Treatment of a non-mechanical paralytic ileus

From: Helen Dynda (
Thu Aug 2 12:46:43 2001

December 20,1999

[] Do you have any information regarding treatment of a non-mechanical paralytic ileus? Non-mechanical paralytic ileus is characterized by a failure of the intestine to propel its contents along, even though the lumen is unobstructed. An alternative name in common usage in the medical literature is chronic intestinal pseudo-obstruction - CIP. It is quite a rare condition (for an overview see Coulie and Camilleri, 1999, and for the nursing aspects see Barr, 1998). The symptoms and signs can be very similar to those of mechanical bowel obstruction, and include pain, vomiting, constipation, and diarrhea (Mann et al, 1997). Weight loss and severe malnutrition can occur in advanced stages of the disorder. Two main types of CIP are recognized:

** myogenic, in which the smooth muscle of the gut wall is affected, and ** neurogenic, caused by abnormalities of the nerve supply to the intestines (Stanghellini, Corinaldesi, and Barbara, 1988).

Management depends on the cause of the disorder, the extent and location of intestine involved, and the severity of symptoms. The goals of treatment are the restoration of normal gut peristalsis and the correction of nutritional deficiencies (Colemont and Camilleri, 1989). General measures include dietary changes (Scolapio et al, 1999), prokinetic agents, and sometimes surgical intervention (Patel and Christensen, 1995; Mann, Debinski, and Kamm, 1997). Some cases are reversible if the causative factor is known (for example: drugs, metabolic abnormalities, or infection). Small bowel transplantation may be a treatment option in certain patients with intestinal failure (Scolapio et al, 1999).

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