Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction. The word 'ileus' is from Ancient Greek eileós (, "intestinal obstruction"). The term 'subileus' refers to a partial obstruction. Signs and symptoms Symptoms of ileus include, but are not limited to: moderate to severe, diffuse abdominal pain constipation abdominal distension nausea/vomiting, especially after meals vomiting of bilious fluid lack of bowel movement and/or flatulence excessive belching Cause Decreased propulsive ability may be broadly classified as caused either by bowel obstruction or intestinal atony or paralysis. However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic pseudo-obstruction, Ogilvie's syndrome. Bowel obstruction A bowel obstruction is generally a mechanical obstruction of the gastrointestinal tract. Intestinal paralysis Paralysis of the intestine is often termed paralytic ileus, in which the intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage of food through the intestine and lead to intestinal blockage. Paralytic ileus is a common side effect of some types of surgery, commonly called postsurgical ileus. It can also result from certain drugs and from various injuries and illnesses, such as acute pancreatitis. Paralytic ileus causes constipation and bloating. On listening to the abdomen with a stethoscope, no bowel sounds are heard because the bowel is inactive. A temporary paralysis of a portion of the intestines occurs typically after abdominal surgery. Since the intestinal content of this portion is unable to move forward, food or drink should be avoided until peristaltic sound is heard, by auscultation (use of a stethoscope) of the area where this portion lies. Intestinal atony or paralysis may be caused by inhibitory neural reflexes, inflammation or other implication of neurohumoral peptides. Risk factors gastrointestinal surgery or other GI procedures electrolyte imbalance (Namely hypokalemia and hypercalcemia) diabetic ketoacidosis (DKA), and other causes of metabolic acidosis hypothyroidism diabetes medications (e.g. opioids or antimuscarinics) severe illness (Inflammation with peritonitis) spinal cord injury, those with injury above thoracic vertebrae 5 (T5) will have hypomotility problems within the bowel acute intermittent porphyria Treatment Traditionally, nothing by mouth was considered to be mandatory in all cases, but gentle feeding by enteral feeding tube may help to restore motility by triggering the gut's normal feedback signals, so this is the recommended management initially. When the