Paralytic Ileus: Treatment, Procedure, Cost and Side Effects

Paralytic ileus or simply ileus is the obstruction created in the intestine because of paralysis in the intestinal muscles. This paralysis doesn’t have to be complete to cause the ileaus, but however the intestinal muscles need to be inactive so that it prevents the flow of food in the intestine which leads to the blockage of the intestines. Paralytic ileus can mostly by cured due to surgery of the abdomen. It is generally caused due to diseases occurring in the intestines, inflammation in the abdomen, spinal injuries or certain drugs. Paralytic ileus should be treated as soon as possible as it can result to vomiting, nausea, abdominal distention and constipation. Since the bowels are inactive, when the doctor tries to hear the bowel movements using a stethoscope, nothing is heard as no activity is present in the bowels.

The treatment of paralytic ileus usually begins by identifying the real cause behind this disorder. Most of the times, medicines are the cause of ileus, in such cases, your doctor can prescribe you another medication so that your intestine movement or motility is stimulated. The most popular medicine is called Reglan (metoclopramide) which cures paralytic ileus. Avoiding the medicines which caused ileus in the first place can also help you get rid of this disorder. However if this medicine is an antidepressant, you should not suddenly stop taking it, as it can be fatal for your mental health. Consulting and taking an opinion of your doctor is the best option in such cases.

During the early stages of paralytic ileus, surgery is not necessary. However, if ileus reaches a stage where medications no longer assists you, going through a surgery can be the best option left. Even after the surgery, you will have to stay in the hospital for quite some time and take proper fluids so that the ileus gets fully resolved. This procedure is known as nasogastric decompression surgery. The surgeon uses a nasogastric tube which helps in suctioning, while the tube does its job, intravenous fluids are continuously given for hydration purposes. The person may or may not be under the influence of anesthesia for this procedure and a long tube is inserted from your nostrils to your stomach. This tube suctions the extra material and air that you would vomit otherwise.

Most of the times, ileus caused due to some surgeries resolve within 2 to 3 days on its own. However, if it doesn’t cure itself then another correction surgery might be required to get rid of paralytic ileus. Apart from treating ileus, nasogastric decompression surgery can also be used during an emergency situation such as, overdosing on harmful pills, swallowing poison deliberately or by mistake, etc. This procedure can only be successful if it is performed within 4 hours of ingesting the poisonous substance. Paralytic ileus caused due to surgery can be corrected by nasogastric decompression surgery which is also known as gastric suction surgery. This procedure keeps you stomach empty and prevents you from vomiting or feeling nausea as you heal. After the surgery you will only be put on thin liquid diet to speed up your treatment.

Apart from curing paralytic ileus, gastric surgery is ideal for patients whose intestines are blocked, during a stomach hemorrhage, cleaning out your stomach for tests like endoscopy, to reduce the risk of aspiration pneumonia, to decompress the stomach and to save the patient’s life if he/she has swallowed poisonous substances.

People who already have major breathing problems should consult a doctor before going for this surgery. Those who get panic attacks and suffer from anxiety related disorders should get a sedative before gastric suction surgery.

Gastric surgery can have rare side effects which may occur if the surgery is not performed properly. These side effects include, difficulty breathing due to the spasm of the vocal cords, the tube may poke a hole in the esophagus, minor bleeding and aspiration pneumonia. Other complications like water intoxication, mechanical injury, hypochloremia, hyponatremia, epistaxis, bradycardia, hypoxia and laryngospasm can also occur

After the surgery, it is vital to maintain a healthy diet and take other safety measures. However, it is important to prevent this disorder because chronic illness or injury is inevitable, but treatment should be started as soon as you feel the early symptoms of ileus crop up.

Most of the times, gastric suction surgery is also performed to confirm bleeding in the upper gastrointestinal tract. It plays an important role in the cooling of hyperthermic patients and can evaluate hematemesis. Usually gastric suction is performed after certain abdominal surgeries where the symptom of a paralytic ileus is felt. After this procedure, you have to stay in the hospital for some time so that the doctor can make sure you are healthy by giving you intravenous fluids. It can take approximately a week to recover completely from this surgery.

The price of gastric suction surgery in India is approximately Rs.3,00,000 to Rs.9,00,000.

The results of the treatment can be permanent if certain precautionary measures are taken to prevent paralytic ileus. If this disorder relapses, it can be cured with the help of medication. However, gastric surgery should again be considered if it becomes severe.

Other than gastric suction surgery, one can go in for other treatment options such as partial obstruction, complete obstruction or oral medications (if the ileus isn’t that severe).