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Measures to prevent prolonged postoperative ileus

Authors
Jörg C Kalff, MD
Sven Wehner, PhD
Babak Litkouhi, MD
Section Editor
David I Soybel, MD
Deputy Editor
Wenliang Chen, MD, PhD

INTRODUCTION

Prolonged postoperative ileus can increase patient pain and discomfort, contributes to prolonged hospitalization, and is a significant burden on the health care system.

There are few effective strategies for managing prolonged postoperative ileus once established, and thus, a more effective overall strategy minimizes factors that may precipitate or exacerbate the condition (table 1).

Measures used to prevent the development of prolonged postoperative ileus are reviewed here. The epidemiology, clinical features, diagnosis and supportive care of postoperative ileus, and prolonged postoperative ileus are reviewed elsewhere. (See "Postoperative ileus".)

PROLONGED POSTOPERATIVE ILEUS

Prolonged postoperative ileus is said to occur when the patient has symptoms or signs of paralytic ileus (obstipation and intolerance of oral intake) that persist for more than three to five days (depending on the nature of the surgery and what is considered "typical"), without evidence for mechanical bowel obstruction or other postoperative complications. (See "Postoperative ileus", section on 'Physiologic versus pathologic postoperative ileus' and "Postoperative ileus", section on 'Diagnosis'.)

Prolonged postoperative ileus can increase patient pain and discomfort, and decreases patient satisfaction with the surgical outcome [1]. Prolonged delays in oral feeding can compromise postoperative nutrition, which can lead to greater postoperative catabolism, poor wound healing, susceptibility to infection, and the need for nutritional support [2,3]. These problems contribute to prolonged hospitalization and are a significant burden on the health care system [4-7].

                      

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 14 00:00:00 GMT+00:00 2016.
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