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| Coquitlam Connection |
| Ileus � The Other Blockage |
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| Why is a person who plays the piano called a pianist, but a person who drives a race car not called a racist? |
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| At the March Rap Session, one of our members asked if anyone had encountered a condition I had never heard of; ileus or intestinal pseudo-obstruction. After hearing her story I was intrigued and decided to research the condition. What is it? Bowel obstructions come in two varieties, mechanical and nonmechanical. Most ileostomates have encountered the mechanical variety, usually when we eat something fibrous and do not chew well enough. Ileus, also call paraletic ileus, is the nonmechanical variety. It happens when peristalsis stops. Peristalsis is the natural wavelike contractions of the intestines which moves material through the bowel. The symptoms can be very similar to those of mechanical bowel obstruction, and include pain, vomiting, constipation, and diarrhea Several causes are cited for ileus: infection of the peritoneum, disruption or lowering of the abdominal blood supply, as well as some drug and diseases. Heart disease or kidney disease when coupled with low potassium levels can also trigger the condition. Certain chemotherapy drugs such as vinblastine (Velban, Velsar) and vincristine (Oncovin, Vincasar PES, Vincrex), also can cause ileus. Diagnosis So how do you know if your bowel obstruction is due to ileus. First see a physician. Ileus is characterized by a few or no bowel sounds which your physician can easily check with a stethoscope. Diagnosis can be confirmed by X rays and CT scans. Blood tests can also be useful in diagnosis. If you do go for X rays note that barium swallows are definitely contraindicated as they can complicated the situation. Barium enemas can be used to visualize blockages but administration can be problematical in persons with ostomies. A soft catheter should always be used in the case of ileostomies. Colostomates who irrigate should bring their irrigation catheter or ask for something similar. Treatment Hospitalization is indicated. Treatment involves rest and intravenous administration of necessary salts, water, and glucose. The stomach/intestinal contents may be removed via a nasogastric tube. Peristalsis usually restarts spontaneously after two to three days of resting the bowel but cisapride and vasopressin may be administered to restore intestinal motility. In cases where a partial mechanical blockage triggered the condition, surgery may be performed. Fortunately ileus is a relatively rare condition. The total rate is about one in one thousand for both mechanical and nonmechanical blockages. (Unfortunately my source did not say what the rate in ostomates was.) Sources: World Medical Encyclopedia http://www.rush.edu/worldbook/index.html http://www.ahealthyme.com/ |