pathophysiology of paralytic ileus, its causes, treatments.

1. PARALYTIC ILEUS
By: Syed Mohammad Arish ayub
American University of Barbados

2. WHAT IS PARALYTIC ILEUS
• It is the inability of the intestines to conduct peristalsis which can lead
to obstruction.
• Also known as functional bowel obstruction.
• Most common form of non mechanical obstruction.

3. PATHOPHYSIOLOGY
• Stressful stimuli to the bowel activates sympathetic NS therefore decreasing
peristalsis.
• Intraoperative manipulation may cause nitric oxide to be released and this
relaxes smooth muscles, decreasing peristalsis.
• Obstruction of the intestine due to paralysis of the intestinal muscles

5. CAUSES
Medication that causes paralytic ileus -
• hydromorphone(Dilaudid)
• morphine
• oxycodone
• tricyclic antidepressants, such as amitriptyline and imipramine
intestinal cancer
Crohn’s disease, which causes the intestinal walls to get thicker due to autoimmune
inflammation
diverticulitis
Parkinson’s disease, which affects muscles and nerves in the intestines

6. SYMPTOMS
• Abdominal cramping
• Appetite loss
• Constipation
• Inability to pass gas
• Stomach swelling
• Nausea
• Vomiting

7. DIAGNOSED
• X-ray
• CT scan
• Ultrasound

8. TREATMENT
• Putting the patient on nothing by mouth status (NPO)
• Inserting a tube in either the rectum or the nose for relief from abdominal
swelling.
• Surgery (e.g. laparotomy)
• IV fluids to prevent dehydration
• Medications such as Enemas, laxatives.

9. REFERENCES
• https://www.medicinenet.com/script/main/art.asp?articlekey=7886
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569564/
• https://emedicine.medscape.com/article/2242141-overview
• https://journals.lww.com/jaaos/Fulltext/2015/06000/Paralytic_Ileus_in_the_Orthopae
dic_Patient.6.aspx
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2501703/

10. THANK YOU