The accurate diagnosis and treatment are very crucial for ‘Ileus’. The intestine is one of the very important digestive organs in our body. If the food passes through our digestive tract which is hallowed organ smoothly, the nutrient can be absorbed into our body properly, and it comes out from the intestine as a stool well. However, when the intestines do not move food through in the normal way, it is called ileus. Ileus can be the sign of cancer, and if it is getting worse, it can be life-threatening. That is why we mentioned that accurate diagnosis and treatment are very important.
What is the cause? The ileus is categorized into the small intestine obstruction or large intestine obstruction. The small intestine obstruction often occurs after abdominal surgery, like 60~85% of the total case of obstructions. The other reasons are Crohn’s disease, cancer, hernia, radiotherapy and so on. The common reason for large intestine obstruction is due to rectal cancer and it can cause 70% of emergency operation. The other reasons are volvulus of the colon (5~15%), adhesion after an operation, diverticular disease and so on.
Main symptoms - Acute stomach pain (every 4-5 min around the belly button) - Vomiting - Abdominal inflation - Constipation - The partial obstruction: gas passing, bowel movement - The total obstruction: constipation If there is severe pain and it lasts consistently, the patient may need to get emergency operation due to no blood circulation in the intestine. In the case of large intestine obstruction, there is abdominal inflammation all of sudden and makes pain. In the severe case, the stool can’t be pass out and makes nausea and vomiting. If there is obstruction at the upper part of the large intestine, the patient may have some symptoms like small intestine obstruction.
How to diagnose? The most important thing when we diagnose ileus, the doctor will ask the patient’s medical history, and he/she listens to the intestine sound. If there is a loud noise in a certain interval, but if obstruction lasts for a long time, there is no sound. In the blood test, the WBC (white blood cell) level and hemoglobin level are elevated. The electrolyte level may be decreased due to vomiting and the kidney function should be checked also. In the image test, a simple x-ray is also important, but to find out the reason for obstruction, the patient should get a CT scan. To check the obstruction location, the CT scan under the contrast media is necessary.
The treatment It is separated into internal treatment and surgical treatment - The internal treatment: First, to increase the volume of vessels, the patient should get IV line fluid which is also helpful to replenish electrolyte. Second, nasogastric decompression, which uses a tube to suction out materials that a person might otherwise vomit up In the case the patient needs to get an operation, the doctor will consider using the antibiotic. If it is necessary, the patient gets stent insertion. With this internal medicine treatment, 67-73% of small intestine obstruction and 75% of large intestine obstruction are treated. - The surgical treatment - Enterolysis - Necrotic enteral resection - Anastomosis after cancer resection - Bypass - Colostomy
Aftercare According to the cause of obstruction and also the treatment, it is different what kind of aftercare the patients should do (diet, exercise, rehabilitation) Generally, the patient should move as much as possible, and the patient should care about the food for a while. Of course, overeating is not allowed. Increasing body temperature is also important to elevate immune function and also the bowel movement. Don’t get stress is also important.
