Your bowel is long hollow tube which consists of small intestine and large intestine. It is almost 28 feet long. Food that enters into the intestine is digested and the nutrients are absorbed in the intestine. Rest undigested material is passed on forwards to form feces. This complete process of movement occurs in wave like contractions. In medical terminology it is called peristalsis. Paralysis of bowel is a condition in which peristalsis slows down or completely stops. It is known as ileus which causes obstruction and blockage of the intestinal content.Bowel paralysis can occur after abdominal surgery, due to certain medications, and diseases such as intestinal cancer and diverticulitis. Main symptoms of bowel paralysis are abdominal cramps, swelling of abdomen, vomiting and nausea, constipation, etc. Paralyzed bowel is a serious condition and prompts immediate treatment to reduce the risk of complications. If conservative treatment fails surgery may be necessary.
Causes Paralyzed Bowel:
Bowel paralysis or in other words paralytic ileus occurs when the nerves innervating the intestinal muscles malfunction. This may cause partial or complete impairment of peristaltic movement leading to accumulation of intestinal content.As the food material cannot pass forward it gets accumulated in the intestine. This leads to obstruction in the intestine. There are several causes of paralytic ileus. It can be a complication of abdominal surgery. The other reasons include:
- Electrolyte imbalance
- Intestinal trauma
- Diseases of intestine such as Crohn’s disease, IBS.
- Rapid loss of weight
- Diabetic ketoacidosis.
- Mesenteric artery occlusion. It is the artery which supplies blood to intestine.
- Use of certain medications such as antidepressant tricyclics, morphine, ocycodone, opium and other sedatives etc.
- Intestinal carcinoma.
- In children intussuception is common cause for intestinal paralysis.
- Radiation in abdominal area.
Paralyzed Bowel Symptoms:
Impaired bowel motility causes discomforting symptoms. Intestinal paralysis can be partial or complete. Paralysis can develop in small intestine or large intestine or in the section of any one of them. The symptoms may be mild in partial ileus where as severe when it is complete. Intestinal paralysis causes obstruction of the content present in it. If small intestine is involved vomiting will occur first and constipation will follow. In case of large intestine obstruction constipation is prevalent first and later there is onset of nausea and vomiting. The symptoms of small bowel paralysis are sudden and while large bowel paralysis symptoms are gradual. Most characteristic symptoms are as follows:
- Abdominal swelling
- Distension of abdomen
- Foul smelling breath.
- Patient is not able to pass gas.
- Absent bowel sound. During examination no bowel sound are heard with a stethoscope.
- Excessive belching
- Increased breathing rate because of abdominal distension and toxicity caused by accumulation of the waste products.
Diagnosis and Treatment:
Bowel paralysis is diagnosed with help of medical history, clinical examination and radiological tests. Patient may give history of the symptoms mentioned above. On clinical examination, the most characteristic feature is absence of bowel sound. Peristaltic movement cannot be heard when stethoscope is pressed over abdomen. X-ray, ultrasound and CT abdomen helps to confirm the diagnosis.
Bowel paralysis is a serious condition and prompt treatment is always recommended. Patient generally is hospitalized once he is diagnosed of this condition. Usually all conservative measures are taken to treat the condition. Patient is kept nil by mouth, meaning nothing is given by mouth. The nutrition is provided through intravenous route. Naso gastric tube is inserted in stomach and content of stomach are aspirated out. The aim is to provide rest to the intestine. Certain medications are also given to the patient so that the intestinal motility is resumed. Treatment will also focus on the underlying cause. Paralytic ileus after surgery usually gets cured after 2 to 3 days. It is very common after abdominal surgeries but at the same time prognosis is good. If there is complete obstruction surgical measures may be needed to remove the blockage. During the surgery a section of intestine may be removed and remaining section is stitched.