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Intestinal paresis after surgery consequences. Postoperative intestinal paresis

About paresis and paralytic ileus intestines, surgeon Elena Repina talks about symptoms, diagnosis and treatment. It's about about acute intestinal obstruction, but there is also chronic intestinal paresis, chronic intestinal obstruction; it has the same symptoms, but slightly different causes. Intestinal paresis is also called enteroparesis (from the Greek πάρεση εντέρου)

What is enteroparesis?

Grandfather, with whom my “baptism of fire” in the department began emergency surgery, I remember it like now: he was lying with a sallow face, with a belly as big as a ball, not seeing his legs. I did an examination at reception department and was ready to open the operating room: the diagnosis of peritonitis was beyond doubt. Imagine my surprise when the senior surgeon pronounced the verdict: “Mesenteric thrombosis and intestinal paresis. We enema and drip.” I carried out this assignment all night, but it never came to the point of surgery. And the next time I saw my grandfather was three days later. He was quite pink and cheerful. I had no idea then that patients with intestinal obstruction would be my daily (and “nightly” reality).

Once upon a time beautiful word“Ileus” reminded me of the “Iliad,” but now it was associated only with an enema. Ileus (from Greek ειλεός) – disruption or complete cessation of the movement of contents gastrointestinal tract due to an obstruction (mechanical ileus, or mechanical intestinal obstruction - CI) or disorder motor activity intestines (dynamic ileus, or dynamic intestinal obstruction - CI).

By the way, in Greek the exclamation “έλεος!” - means “Have mercy!” Have mercy!”, and this most accurately defines the reaction to the most serious catastrophe.

Stress or relax? That is the question…

Types of dynamic KN
Dynamic CI is always a secondary disease. It is assumed that this is a physiological protective reaction of the body: under the influence of strong stimuli, it “saves” energy, which is spent on peristaltic waves. In 12% of cases, this reaction takes the form of intestinal spasm (spasmodic CI). This may be caused by diseases of the brain and spinal cord, ingestion of salts into the body heavy metals and even hysteria (hysterical ileus).
Most often the intestines (88%) react to severe stressful situations for the body through paresis (weakening of motor function due to decreased muscle strength) or paralysis (muscles stop producing a peristaltic wave). On the one hand, the reaction is understandable: why take away strength from the body? Let him fight his “enemies”, but I won’t interfere, I’ll freeze here, hide... On the other hand, paralytic ileus significantly worsens the patient’s condition. Most often, the nature of such changes is acute (for example, postoperative peritonitis), against this background acute CI develops. Less commonly, it is in the nature of permanent changes (for example, thrombosis of mesenteric vessels), accompanied by periods of improvement and deterioration. More often, such patients develop chronic intestinal paresis and a tendency to constipation.

Why, why did he have to freeze?

Paralytic obstruction is treated conservatively

Reasons for the development of paralytic CI
The most common reason acute intestinal paresis - surgical intervention, especially under general anesthesia. Intestinal paresis in the first three days after surgery is a common phenomenon and resolves on the third day, when stool passage should improve. If the resolution of paresis is delayed, sluggish peritonitis with eventration (turning the intestine “inside out”) may occur.
All reasons can be conditionally grouped depending from the primary source of the disease:

Abdomen

All organs abdominal cavity interconnected. The intestine quickly receives a signal about changes that have occurred in other organs and the peritoneum, and “freezes” in the following situations:

with blunt abdominal trauma;
when inflammation occurs, requiring surgical intervention(appendicitis, cholecystitis, pancreatitis);
with the development of peritonitis (infection entering the abdominal cavity as a result of intestinal perforation or aseptic inflammation due to the ingestion of bile or pancreatic secretions);
in the early postoperative period;
damage to the mesenteric arteries due to aortoarteritis or embolism or thrombosis of the mesenteric veins.

Retroperitoneal space and pelvis

In some diseases of the retroperitoneal and pelvic organs, reflex intestinal paresis occurs:

pyelonephritis or inflammation of the retroperitoneal tissue;
retroperitoneal hematoma (usually due to injury);
ureteral obstruction;
urinary retention, uremia;
tumors or metastases of the retroperitoneal and pelvic organs;
fracture of the pelvic bones.

Other organs

injury or tumor of the brain or spinal cord;
lung diseases (pneumonia, pleural empyema);
thromboembolism of the pulmonary arteries.

General diseases

sepsis;
hypothyroidism;
diabetes ();
metabolic disorders accompanied by the development of potassium and sodium deficiency;
impact medicines(For example,)

How does this happen?

Pathogenesis of the disease

In response to exposure to any irritant, a reflex restriction of intestinal motor activity occurs. The chain of this reflex is closed not only in the head, but also in the spinal part of the central nervous system. Under these conditions, intraintestinal pressure increases, and the vessels of the intestinal walls are subjected to compression. The blood supply to the nerve plexuses is disrupted, which threatens the transition of paresis (functional damage) to organic damage to the nerve endings.
The absorption of fluid and electrolytes from the intestinal lumen is impaired, and the volume of circulating blood decreases. Due to a pathological increase in the permeability of the intestinal wall, bacteria can penetrate into the blood.
Damage to the microvasculature and peripheral apparatus of intestinal nerve receptors depends on the state of the body and the time that has passed since exposure to the stimulus. Early detection intestinal paresis will contribute to better treatment results.

You will recognize her... by the cessation of passing gas

Clinical picture of paralytic CI
The disease is characterized by a tetrad of symptoms:

cramping abdominal pain;
repeated vomiting, first with the contents of the stomach, then the intestines;
bloating with visible asymmetry;
stopping the passage of stool and gas.

Conventionally, the course of the disease is divided into several stages.
At the first stage there are no organic changes in nerve receptors and intestinal vessels.

Symptoms: vomiting of gastric contents, not profuse, the abdomen is evenly and moderately distended, peristalsis can be heard. No profound hemodynamic or electrolyte changes were observed.

In the second – against the background of deterioration of microcirculation traumatization occurs to the nerve receptors of the intestinal wall.

The condition can be severe, symptoms intensify: shortness of breath occurs, cardiopalmus, increase blood pressure. There may be vomiting of intestinal contents, single peristalsis, almost unheard.

The third is characterized by a very serious condition, a decrease in the volume of circulating blood, the volume of urine excreted decreases until it stops. The pressure drops to 90 mmHg, shortness of breath and tachycardia continue. The abdomen is sharply swollen, peristalsis is not heard.

Treatment of paralytic CI

Treatment of paralytic intestinal obstruction is conservative. Surgical intervention for paralytic CI will only aggravate its manifestations, I learned this from my first duty.
To prevent postoperative paresis, experienced surgeons always, during the operation, carry out abundant infiltration of the mesentery with novocaine solution and start nasogastric tube.

The main stage of treatment is eliminating the root cause of the development of paralytic ileus or primary focus pathological impulses.

For persistent intestinal paresis, an epidural block is used. To restore autonomic innervation, atropine and proserine are used.
The problem of intestinal decompression is solved by a nasogastric tube and.
Use any methods of reflex influence on intestinal motor activity: early stages Electrical stimulation of intestinal peristalsis, massage, acupuncture, and irritation of the rectum with a gas outlet tube are effective.
Carrying out intensive infusion therapy is an integral part of treatment. Its goal is to eliminate hypovolemia, restore impaired water and electrolyte balance, correct metabolic disorders, and antihypoxic therapy.

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... is the second most frequently observed postoperative complication.

Definition. The term “postoperative intestinal paresis” (PPP) is understood as depression of the motor activity of the gastrointestinal tract in the form of impaired evacuation of its contents, which is objectively manifested by a weakening of intestinal sounds, accumulation and delay in the passage of gases and stools in the patient, more or less pronounced bloating in the first 72 hours after surgery. Many authors assess the development of PPC as a protective reaction to surgical trauma in the next 2 to 3 days after surgery.

There is no single term in the literature to denote the condition resulting from a violation motor activity intestines in the postoperative period. This condition is called “postoperative flatulence”, “dynamic intestinal obstruction”, “functional intestinal stasis”, “postoperative functional intestinal obstruction”. However, the term PPC is now increasingly used, which indicates that the leading one is a violation of intestinal motor function that appears in the postoperative period.

Pathogenesis. The development of PPC after surgical interventions is a complex staged process. It is believed that in the initial phase of development, paresis has a functional genesis and is associated with an emerging stress imbalance in the neurohumoral regulation of intestinal motor activity, occurring at the extra- and intramural level. A number of researchers believe that one of the factors in the development of PPC is severe water and electrolyte disturbances in the preoperative period, especially potassium deficiency.

According to classical concepts, disturbances in the motor function of the gastrointestinal tract in the early postoperative period are caused by stimulation of inhibitory neuroendocrine influences caused by hypertonicity of the sympathetic nervous system, which has an inhibitory effect on gastrointestinal motility. Subsequently, when the movement of intestinal contents is delayed, sharp increase microflora, changing its character. In this case, one of its main functions is often lost – antagonistic activity towards opportunistic and pathogenic microorganisms. The latter multiply intensively and begin to function actively, as a result of which the transport of electrolytes is disrupted and secretion into the intestinal lumen increases. The resulting putrefaction products, in combination with an increasing amount of microbial toxins, make the contents of the paretically altered intestine extremely toxic. Overstretching of the intestinal tube by gases, impaired microcirculation and the direct effect of toxic substances on the intestinal mucosa lead to disturbances in its barrier function. Most often, paresis of the gastrointestinal tract occurs after extensive abdominal surgery, which is associated with:

biological activity

Diagnostics PPC in the early postoperative period. Until now, objective methods of monitoring the state of activity of the gastrointestinal tract organs have not been sufficiently introduced into clinical practice. Many authors limit themselves only to indicators of the timing of the passage of gas and the appearance of the first stool. The most promising, reasonable and non-invasive method for assessing the motor-evacuation function of all parts of the gastrointestinal tract is the method of peripheral electrogastrointestinography.

Principles of treatment PPK. On modern stage, then most authors are inclined to complex therapy aimed at a pathogenetic solution to this problem. According to Livingston E.N. (1990), nasointestinal intubation remains the only effective treatment for paresis. IN Lately The early start of enteral (tube) nutrition, which contributes to an earlier restoration of the functional activity of the gastrointestinal tract, also turned out to be promising. A number of authors note a positive effect on intestinal motility in the postoperative period. chewing gum in patients with postoperative paresis. There is evidence of a positive effect on the motility of the gastrointestinal tract using probiotics in the pre- and postoperative period in surgical patients. Many authors suggest various schemes medication to resolve postoperative paresis. In normal clinical practice The main drugs for the treatment of paresis remain anticholinesterase drugs (prozerin, ubretide, etc.), metoclopramide, erythromycin, etc. (adrenergic blockers, sympatholytics). But their effectiveness is not always clear, and side effects expressed.

A number of studies have proven that espumizan (simethicone) can be recommended as effective remedy to restore normal intestinal motility in the early postoperative period in patients who have undergone laparoscopic surgical interventions on the abdominal organs and other surgical interventions without surgical damage to the esophagus, stomach, intestines (espumisan in the form of an emulsion, 2 teaspoons 3 times a day for 2 days before surgery, from the end of the 1st day after surgery and for the next 5 days at the same dosage).

The most pathogenetically substantiated treatment for PPC is the use of serotonin, which (in doses of 0.1 mg/kg [Klimov P.K., 1976]) causes strong peristaltic activity of the stomach and small intestine(results confirmed by electrophysiological and X-ray examinations). Clinical observations describe the positive experience of using serotonin adipate when administered intravenously in an amount of 20 - 60 mg per day per day. early dates postoperative period to restore peristalsis in functional intestinal obstruction. At the same time, the duration of drug administration ranged from 2 to 5 days, satisfactory results were obtained. clinical results associated with the rapid normalization of intestinal motility.

There are painful conditions of the body, such as constipation or bloating, for which people, as a rule, do not like to see a doctor. However, such symptoms may indicate intestinal paresis, a pathology that accounts for up to 0.2% of cases in surgical practice. total number diseases.

Concept and code according to ICD-10

Intestinal paresis or ileus is a condition in which the movement of contents through it is disrupted due to a decrease or absence of peristalsis (intestinal muscle tone). Feces stagnate, which leads to intoxication of the body, and in especially severe cases requires surgical treatment.

This pathology is more common in older people who have chronic diseases internal organs or in patients who have undergone surgery. However, intestinal paresis can occur in newborns, as well as in pregnant women, which is dangerous for both mother and child.

Disease code according to ICD-10:

K56.0- paralytic ileus of the intestine, colon, small intestine.

Reasons for development

Impaired intestinal motility often occurs after surgical interventions or against the background of diseases of internal organs - lungs, heart, gastrointestinal tract.

Paresis may occur due to circulatory disorders when:

rupture;
insufficiency.

Also the reason may be inflammatory processes in the abdominal cavity:

phlegmon;
peritonitis.

In other cases, paresis occurs due to a disorder of intestinal innervation when:

taking calcium channel blockers;
spinal cord damage due to trauma;
inhibition of acetylcholine synthesis in nerve endings;

Hepatic or renal colic can also cause reflex intestinal paresis. Patients at risk are those taking medications that can inhibit intestinal motility and those who have serious metabolic disorders.

Degrees

In the pathogenesis of intestinal paresis, three stages of pathology development are distinguished:

Symptoms

The main complaints of patients with intestinal paresis:

constipation;
bloating;
vomit;
nausea;
moderate diffuse pain;
difficulties with the passage of gases.

The temperature is usually low-grade; its increase may indicate complications (peritonitis,).

A significant accumulation of gases in the intestines leads to displacement of the diaphragm and pressure on the organs of the chest cavity. In this regard, the following may occur:

dyspnea;
rapid breathing;

In turn, prolonged vomiting can lead to vomiting, which is manifested by dry mucous membranes and decreased urination.

Leakage in children

Paresis can occur in children for the same reasons as in adults, but since young children cannot talk about their symptoms, it is necessary to pay attention to the following:

unpleasant and painful sensations in the stomach they make the child feel restless, small children press their legs to their stomach or twist them;
absence of bowel movements, or slight passage of liquid intestinal contents;
the abdomen is uniformly enlarged and swollen, pain occurs on palpation;
breathing becomes noisy and frequent;
Bile may be present in the vomit.

Diagnostics

During examination by a surgeon and gastroenterologist, it is excluded mechanical reasons paresis, and also establish etiological factors intestinal motility disorders. Are used following methods diagnostics:

. Intestinal loops filled with gas are visualized and the absence of mechanical factors is stated.
. Allows you to identify stretched intestinal loops and circulatory disorders.
MSCT. The presence of gas in the thickness of the intestinal walls and the degree of ischemia are determined.
. Paresis is indicated by filling the large intestine with contrast agent in less than 4 hours.

Therapy methods

Patients with intestinal paresis are hospitalized and treated in the surgery department or intensive care. After their condition improves, they are transferred to the gastroenterology department and prescribed conservative therapy, including:

removal of intestinal gases using a rectal tube or thick gastric tube;
diet prescription;
treatment of the underlying disease that caused paresis;
correction of metabolic disorders.

Conservative treatment includes the prescription of medications (Neostigmine) to stimulate intestinal motility. The following methods are used for intestinal decompression:

insertion of a probe under x-ray;
percutaneous cecum;
colonoscopy;
percutaneous cecostomy.

In the case when all of the above methods are not effective enough, open surgery with resection of part of the affected intestine. After surgery, analgesics and anesthetics, as a rule, are not prescribed, as they can inhibit peristalsis.

Treatment of postoperative intestinal paresis

Often the cause of paresis is a violation of peristalsis due to surgical and other interventions. A weakened intestine loses motor reflexes, which may stop altogether.

For this, electronic units are used, thanks to the impulses of which spasms are relieved and blood circulation in this digestive organ is restored.

Possible complications of the disease

Complications of paresis include:

ischemia of the intestinal walls followed by perforation;
peritonitis;
intestinal bleeding;
formation .

Prognosis and prevention

The outcome of the disease varies depending on the presence of complications and the age of the patient. The greatest mortality is observed with perforation of the intestinal wall and the occurrence of peritonitis.

There is no specific prevention of the disease. Timely contact with a specialist in case of any discomfort from the gastrointestinal tract will help protect against complications of paresis.

Intestinal paresis is its temporary non-functionality, or more precisely, a disruption of habitual motor activity, which in medicine is called peristalsis. Intestinal paresis can spread to a specific area or disrupt the activity of the entire gastrointestinal tract.

With this disease, three main stages of development can be distinguished. Intestinal paresis occurs according to the following scenario: first, the motor activity of the digestive organ is disrupted and intestinal paresis develops, then the main functions of muscle contraction gradually slow down and disappear, the patient may experience increased gas formation, fluid accumulates in the intestines, which increases pressure. This picture of the development of the disease leads to impaired blood circulation in all linings of the intestine. Paresis is accompanied by general intoxication, which negatively affects the condition of the body; here the patient cannot help but notice a deterioration in well-being and problems with digestion.

The occurrence of pathology

Intestinal paresis is referred to by specialists as paralytic ileus. This disease very often occurs as a disorder after surgical interventions in the patient’s body. As a rule, this diagnosis is typical for patients who, as a result of forced surgical procedures in the intestines are susceptible to water imbalance. Often, a diagnosis such as intestinal paresis is made to the patient on the third day after surgery.

Very often, intestinal paresis is accompanied by a significant enlargement of the stomach. Of course, it is impossible to name only one reason for impaired intestinal motility. Among the factors contributing to the onset and progression of the disease, it is necessary to mention many other diseases and pathologies that reduce functionality digestive system. For example, such diseases include peritonitis, inflammatory processes in the intestines, hematomas or tumors.

Paralytic ileus may also contribute to urolithiasis disease or previous trauma in the abdominal area. People who have suffered pleuropneumonia or myocardial infarction are also at risk.

Less common causes of intestinal paresis include the following:

impaired metabolism due to lack of magnesium and potassium in the body;
chemical poisoning;
thrombosis;
diabetes;
kidney problems;
lung diseases;
pneumonia.

Of course, all of the above reasons cannot completely affect the functioning of the intestines. For example, after surgery to restore normal functions This body needs about three days. However, it is extremely rare for the intestines to completely stop working.

Postoperative paresis and its symptoms

Symptoms of intestinal paresis are very similar to ordinary diseases and cases of poisoning, when the entire gastrointestinal tract system is affected. Postoperative paresis intestines (ppk) is accompanied by a feeling of nausea, vomiting, and bloating. The patient will feel pain symptoms in the abdominal area, which are colicky in nature. Many people with such sensations do not attach much importance to the symptom and refer to simple mechanical obstruction of gases.

For intestinal paresis characteristic symptom There will also be frequent passage of small masses of feces, which have a liquid consistency, while normal stool may be delayed.

Excessive bloating causes the diaphragm to become displaced. From this appear additional symptoms: heavy breathing, shortness of breath, increased blood pressure, tachycardia. Also, patients often present with symptoms of dehydration, because frequent vomiting The skin begins to dry out and the mucous membranes become dry.

Diagnostic methods

It is quite logical to consult a gastroenterologist for advice in case of any disturbances in the digestive system. However, the surgeon can carry out initial diagnostic methods and understand the reasons for the patient’s complaint. An experienced specialist will be able to determine intestinal obstruction, exclude any mechanical influences on the functioning of the intestines, and establish the cause of intestinal paresis.

The simplest and most easily tolerated method for diagnosing paresis is considered to be radiography of the patient’s abdominal cavity. This procedure is carried out in three human positions: horizontally, vertically and laterally. In this case, the doctor receives images that clearly show the loops small intestine, which are evenly filled with gas, and the colon will most often be overfilled with liquid.

More sensitive and less commonly used examination methods include ultrasound or MSCT. With the help of such procedures, it is possible to identify stretched intestinal loops, the same horizontal fluid level and increased pneumatization of the intestine.

Therapeutic actions

Intestinal paresis is a disease that can occur in newborns, adolescents, and adults. Depending on this, treatment methods of this disease can also be divided into three main groups.

So, if we are talking about a newborn, then his peristalsis may be weakened as a result of a disruption in the formation of the nervous system. Therefore, the treatment of such children will be aimed at restoring this gastrointestinal tract reflex. Also in this case, it is necessary to restore blood circulation in the walls of the newborn’s intestines, enhance metabolism, and normalize the tone of the muscles of the digestive organ. To normalize all of the above functions, it is customary to use an electrical stimulator, which eliminates all disorders associated with the baby’s underdeveloped nervous system. Thanks to this device, the problem can be solved within a few days.

For adolescents and adults, very often the cause of paresis is damage to the intestinal microflora due to surgical or traumatic actions. Almost any intervention weakens the intestines or completely stops its motor reflexes. Many experts recommend immediately after an injury or any surgery to undergo procedures aimed at restoring the digestive organ. For this, doctors use special electronic units.

In adults, intestinal paresis can be caused by past or chronic diseases Gastrointestinal tract, excessive use of laxatives, physical inactivity, spinal injuries that compress the nerves responsible for regular intestinal contractions. In all such cases, it is also advisable to use an electrical stimulator, which will help relieve muscle spasms and improve blood circulation in the intestines.

In addition to such procedures, the patient will have mandatory Constant suction of secreted fluid from the intestine was prescribed. This method is called naso-gastric and is done using a special tube. During treatment and recovery, the patient must exclude the usual intake of food and liquids by mouth. In addition, the doctor prescribes medicinal sedatives and psychotropic substances.

In cases where bowel function still does not improve after a week of treatment, the patient is prescribed a laparotomy.

It is also possible to stimulate intestinal activity using a simple gas outlet tube, which is inserted into the rectum. More loyal methods of treatment include abdominal massage and compresses that will irritate the intestines.

Preventive actions

If you are undergoing surgery in the abdominal area, you can take care of yourself in advance and prevent postoperative intestinal paresis.

If possible, try to choose more modern and less traumatic methods of surgery. For example, ask your doctor if the prescribed operation can be performed not using abdominal intervention, but prefer laparoscopy. And in cases that already exist serious illnesses gastrointestinal tract, it is necessary to perform intestinal stimulation and nasogastric aspiration immediately after surgery, without waiting for complete organ failure.

With a gradual decrease in intestinal muscle tone with the development of paralysis due to severe diseases of the gastrointestinal tract and other body systems, intestinal paresis develops. Symptoms of the condition are characterized by uniform bloating, nausea, ending with vomiting, acute dehydration, tachycardia, and respiratory dysfunction. Paresis is diagnosed by X-ray and ultrasound methods, tomography, colonoscopy and irrigoscopy. Treatment involves A complex approach, including motor stimulation, elimination symptomatic manifestations, performing intestinal decompression. More often surgery is required.

General information about pathology

Intestinal paresis is a temporary weakening of the peristaltic activity of the intestinal tract, which often develops against the background of a disorder of water and electrolyte balance due to surgery on the organ itself or in another part of the abdominal cavity.

Other names for the pathology are ileus, atony,. Symptoms of the disease appear on the 2-3rd postoperative day. Atony is possible in one section of the intestine or paralysis of the entire section is possible.

When there is poor intestinal permeability due to paresis, the following appear:
severe, widespread bloating in the abdomen;
increased flatulence; spilled, nagging pain
, covering all parts of the intestine;
constant nausea with vomiting, in the masses of which there are blood streaks, bile, gastric or intestinal contents;
problems with stool excretion, in particular, the appearance of a small volume of liquid stool;
soft, relaxed abdomen; intermittent breathing, tachycardia with sharp decline

Blood pressure due to distension and swelling of the intestinal walls.

Disease incidence

Pathologies of internal organs lead to the development of intestinal paresis. Intestinal paresis is a common disorder and manifestation of diseases of other organs. In 25% of patients, paralysis appears when acute diseases surgical intervention in the gastrointestinal tract, but only 0.2% of patients with this symptom underwent surgery for another reason. 70% of patients are people over 60 years old. The disease may occur in newborns and older children, in women during pregnancy (2nd, 3rd trimester) and after childbirth.

Phases of development

Intestinal paresis develops in 3 stages:

1st, when there is a gradual or sudden inhibition of peristalsis with the development of paresis;
2nd, when peristalsis stops altogether, and against the background of increased formation of gases and accumulation of fluid in the intestine, pressure rises, blood supply is disrupted;
3rd, when, against the background of intestinal blockage, the body is poisoned, the condition worsens, and other organs and systems become disordered.

Provocateurs of intestinal paresis

Causes can be primary or secondary. If paresis occurs due to surgery, abdominal trauma, or violation metabolic processes atony develops independently. If the cause is damage to the mesentery (in particular, its artery), the occurrence of inflammation in any organ of the gastrointestinal tract, the development of other serious diseases in the abdominal cavity and pelvic organs, peritonitis (inflammation of the abdominal sheets), a secondary, symptomatic form of paresis develops.

Main reasons for development:

side effects of opiates, calcium duct blockers and similar medications;
hypokalemia (impaired metabolism);
acute peritonitis;
tumors, cysts, hematomas that provoke inflammation in the intestines;
kidney disease;
pathologies of the sternum (rib fractures, myocardial infarction, pleuropneumonia);
diabetes.

After childbirth, intestinal problems arise, which soon go away.

Ileus develops in women after childbirth as a result of weakening/absence of intestinal motility in the first 24 hours after delivery. With normal recovery, the condition returns to normal within 2-3 days. If gases do not pass on the 4th day, the doctor diagnoses paresis and prescribes treatment. In newborns, paresis develops due to congenital or acquired disorders of the nervous system. In infants, ileus is a consequence of poor nutrition, treatment of certain infectious diseases.

Postoperative paresis: description, symptoms

Atony is a common consequence abdominal surgery(operations on internal organs peritoneum). In most cases, the disorder does not require treatment, as the condition resolves itself after a few days. But complications may develop.

The symptoms of the condition are determined by the degree of paresis:

With 1st degree damage, the condition is characterized by a temporary reaction of the body to injury in the form of gastrointestinal dysfunction. With proper medical care of the patient, no treatment is required; recovery occurs on its own.
With 2nd degree damage, the dysfunction is more profound and is manifested by a feeling of heaviness in the stomach, nausea with vomiting, and tolerable bloating. Symptoms develop against the background of stagnation of food chyme (lump), problems with the movement of food through the gastrointestinal tract. The condition requires infusion treatment aimed at regulating water-electrolytic and acid-base balance. Evacuation from the stomach to the intestines can be improved by introducing a probe or motor stimulation.
With stage 3 damage, intestinal paresis is accompanied by severe bloating, constant feeling gastric surges. In the presence of postoperative intestinal paresis, treatment regimens are used aimed at preventing complete paralysis of the intestinal muscles.

Examination methods

Methods for diagnosing diseases of the gastrointestinal tract include palpation.

Problems with intestinal peristalsis a gastroenterologist and a surgeon are involved. Doctors perform examination, palpation and percussion (listening to the intestines) to identify intestinal obstruction and suggest the underlying causes of the condition. Then assigned comprehensive examination patient using the following instrumental methods:

Treatment of intestinal paresis is carried out in intensive care. The first stage of the treatment regimen is unloading the intestines - gases are removed through outlet tubes (rectal probes). Additionally, fasting is prescribed to reduce the load on the gastrointestinal tract, primary pathology is treated, and water-electrolyte balance and metabolism are improved. Moderate physical activity and abdominal massage are recommended.