Abstract
Background:
Postoperative ileus is common and is a major clinical problem. It has been widely studied in patients and in experimental models in laboratory animals. A wide variety of treatments have been tested to prevent or modify the course of this disorder.
Purpose:
This review draws together information on animal studies of ileus with studies on human patients. It summarizes some of the conceptual advances made in understanding the mechanisms that underlie paralytic ileus. The treatments that have been tested in human subjects (both pharmacological and non-pharmacological) and their efficacy are summarized and graded consistent with current clinical guidelines. The review is not intended to provide a comprehensive overview of ileus, but rather a general understanding of the major clinical problems associated with it, how animal models have been useful to elucidate key mechanisms and, finally, some perspectives from both scientists and clinicians as to how we may move forward with this debilitating yet common condition.
Keywords:
ileus; intestinal nervous system; postoperative.
© 2020 John Wiley & Sons Ltd.
MeSH terms
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Anesthesia, Epidural
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Animals
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Benzofurans / therapeutic use
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Chewing Gum
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Cholinergic Agents / therapeutic use
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Contrast Media / therapeutic use
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Cyclooxygenase Inhibitors / therapeutic use
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Diatrizoate Meglumine / therapeutic use
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Digestive System Surgical Procedures / methods
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Enhanced Recovery After Surgery
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Enteral Nutrition
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Enteric Nervous System / physiopathology*
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Fluid Therapy
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Gastrointestinal Agents / therapeutic use
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Gastrointestinal Motility / physiology*
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Ghrelin / therapeutic use
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Humans
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Ileus / immunology
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Ileus / physiopathology*
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Ileus / prevention & control
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Ileus / therapy
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Inflammation / immunology
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Intestinal Pseudo-Obstruction / immunology
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Intestinal Pseudo-Obstruction / physiopathology
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Intestinal Pseudo-Obstruction / prevention & control
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Intestinal Pseudo-Obstruction / therapy
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Intubation, Gastrointestinal
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Laparoscopy
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Mast Cells / immunology
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Piperidines / therapeutic use
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Postoperative Complications / immunology
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Postoperative Complications / physiopathology*
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Postoperative Complications / prevention & control
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Postoperative Complications / therapy
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Serotonin 5-HT4 Receptor Agonists / therapeutic use
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Sympathetic Nervous System / physiopathology*
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Sympatholytics / therapeutic use
Substances
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Benzofurans
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Chewing Gum
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Cholinergic Agents
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Contrast Media
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Cyclooxygenase Inhibitors
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Gastrointestinal Agents
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Ghrelin
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Piperidines
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Serotonin 5-HT4 Receptor Agonists
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Sympatholytics
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prucalopride
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Diatrizoate Meglumine
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alvimopan