gastrointestinal disorders
Ileus
Treatment of Ileus
Nasogastric suction IV fluids Treatment of ileus involves continuous nasogastric suction, nothing by mouth, IV fluids and electrolytes, a minimal amount of sedatives, and avoidance of opioids and anticholinergic medications. Maintaining an adequate serum potassium level (>4 mEq/L [>4.00 mmol/L]) is especially important. Ileus persisting>1 week probably has a mechanical obstructive cause, and laparotomy should be considered. Sometimes colonic ileus can be relieved by colonoscopic decompression; rarely, cecostomy is required. Colonoscopic decompression is helpful in treating pseudo-obstruction (Ogilvie syndrome), which consists of apparent obstruction at the splenic flexure, although no cause can be found by contrast enema or colonoscopy for the failure of gas and feces to pass this point. Some clinicians use IVneostigmine(which requires cardiac monitoring) to treat Ogilvie syndrome. 