Paralytic Ileus: Symptoms, Treatment, and Recurrence Risks

Paralytic ileus

Two weeks ago, I started experiencing abdominal pain, vomiting, diarrhea, and intermittent cold sweats.
Yesterday, a doctor at another hospital diagnosed me with "paralytic ileus" after an X-ray was taken.
Six years ago, I had abdominal surgery.
Previously, I visited a small clinic for my vomiting and diarrhea issues, where they diagnosed me with gastroenteritis, but the medication provided did not lead to significant improvement.
Since two weeks ago, most of my diarrhea has been watery, with no formed stools.
I often vomit about one to two hours after eating, feeling very bloated in my abdomen before vomiting.
Currently, the doctor at the hospital has prescribed Mopride 5mg, Kaolin+(Bio)2C)3+A1-(KBT) Defense 300mg, and Antibiophilus 250mg.
So far, the vomiting has stopped, but I am still experiencing watery diarrhea, and my abdominal bloating varies.
Occasionally, I still feel nauseous.
Will these medications help improve my condition? This is my second episode; the first one only involved abdominal pain, but this time I have more issues.
Is there a chance of recurrence? Are there any solutions? The hospital doctor mentioned that it is a paralytic ileus in the small intestine.

Doris, 40~49 year old female. Ask Date: 2011/06/23

Dr. Xiao Jingqin reply Internal Medicine

If it is indeed a case of paralytic ileus in the small intestine, the symptoms are usually quite severe, and the majority of patients require hospitalization.
Vomiting can be intense, making it nearly impossible to eat.
The upper gastrointestinal tract may produce vomiting due to a large amount of digestive fluid and food that cannot pass into the colon, resulting in the expulsion of dark green bile-stained vomit.
The causes of paralytic ileus in the small intestine include: 1.
postoperative adhesions 2.
intussusception 3.
volvulus 4.
electrolyte imbalances 5.
tumors, among others.
Due to the inability to eat and significant fluid loss into the gastrointestinal tract, intravenous fluid therapy is often necessary during hospitalization.
If symptoms do not improve after several days, surgical intervention may be required (a CT scan should be performed beforehand).
I believe your symptoms are not at this level, as your intestines are still patent (you have had multiple bowel movements).
Regarding medication, the prescription seems reasonable.
If diarrhea persists, you might consider increasing the dosage of KBT to absorb excess water from the stool, thereby firming it up, or adding gas relief medications such as Gascon.

Reply Date: 2011/06/23

More Info

Paralytic ileus is a condition characterized by a temporary cessation of bowel movement, leading to symptoms such as abdominal pain, bloating, nausea, vomiting, and diarrhea. It can occur after abdominal surgery, as in your case, or due to various other factors, including infections, certain medications, and electrolyte imbalances. Given your history of abdominal surgery six years ago, it is possible that adhesions or other complications from that surgery could be contributing to your current symptoms.

Symptoms and Diagnosis
The symptoms you are experiencing—abdominal pain, vomiting, and diarrhea—are consistent with paralytic ileus. The fact that you have been experiencing watery diarrhea and have difficulty keeping food down suggests that your intestines are not functioning properly. The diagnosis is typically confirmed through imaging studies, such as X-rays or CT scans, which can show distended loops of bowel and the absence of normal peristalsis.

Treatment Options
The treatment for paralytic ileus often involves supportive care. This may include:
1. Bowel Rest: Avoiding oral intake for a period to allow the intestines to recover.

2. IV Fluids: To maintain hydration and electrolyte balance, especially since you have been experiencing vomiting and diarrhea.

3. Medications: The medications prescribed to you, such as Mopride (a prokinetic agent), can help stimulate bowel movement. Kaolin and antibiotics may also be used to manage diarrhea and prevent infection.

4. Monitoring: Close observation in a medical setting to ensure that the condition does not worsen.

Recurrence Risks
Regarding the risk of recurrence, it is important to understand that paralytic ileus can occur more than once, especially in individuals with a history of abdominal surgery or other underlying gastrointestinal issues. Factors that may increase the risk of recurrence include:
- Previous abdominal surgeries
- Presence of adhesions
- Certain medications that can slow down gut motility
- Electrolyte imbalances

Prevention and Management
To reduce the risk of future episodes, consider the following strategies:
1. Dietary Adjustments: After recovery, gradually reintroduce foods that are easy to digest. High-fiber foods can help maintain regular bowel movements.

2. Hydration: Ensure adequate fluid intake to prevent dehydration, especially if you experience diarrhea.

3. Medication Review: Discuss with your healthcare provider any medications you are taking that may contribute to gastrointestinal motility issues.

4. Regular Follow-ups: Keep regular appointments with your healthcare provider to monitor your gastrointestinal health, especially if you have a history of issues.

Conclusion
In summary, while the medications you are currently taking may help alleviate some of your symptoms, it is crucial to follow up with your healthcare provider to monitor your condition closely. If symptoms persist or worsen, further evaluation may be necessary to rule out any complications. It is also essential to discuss any concerns about recurrence and preventive measures with your doctor. Remember, effective communication with your healthcare team is key to managing your condition and ensuring a better quality of life.

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