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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Management of paralytic ileus is summarised by the usual management phrase in obstruction: drip and suck, i.e.:

  • nasogastric suction, used only if necessary, i.e. due to vomiting and gastric distention
  • fluid requirements given intravenously
  • patient kept nil by mouth; may be given small sips of water to drink or ice cubes to suck
  • check for and correct any fluid/electrolyte disorder
  • observe for signs of recovery from ileus
  • further management depends on the cause of ileus: if the ileus persists for more than 4 days postoperatively then this suggests some other cause than just postoperative reflex paralytic ileus
  • colonoscopy permits decompression of the gut while simultaneously conclusively establishing the diagnosis
  • if there is caecal perforation or if the patient's general condition deteriorates then a caecostomy with the insertion of a wide-bore catheter is indicated

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