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Treatments
Medical care
Intravenous
hydration NGT (if necessary) for relief the symptoms not proven scientifically
Correcting
the sepsis and electrolyte abnormality: hypoK, hypoNa, hypoMg Diminishing of narcotic usage Discontinue the drug such as opiate
Diet
Delaying
oral feeding until ileus resolves clinically Chewing gum increasing early recovery scientifically proven (3:6)
Activity
The ambulation stimulates bowel function (conventional) scientifically non proven (day 1 and day 4) Effective to prevent atelectasis, deep vein thrombosis, and pneumonia
Suppositories and enemas no clinical benefit Erytromycin (a motilin receptor agonist) no clinical benefit
Rectal cisaprite (a serotonin agonist) moderate beneficial banned by FDA cardiac dysarithmia Metoclopramide (a dopaminergic agonist) worsen the ileus
peripheral mu-opioid receptors Abolishing the adverse gastrointestinal effects of opioids without impairing the analgesic effects of such drugs.
Indicated
Alvimopan
Dose:
12 mg po 0.5-5 hrs (single dose) pre operative and 12 mg/day after surgery (7 days) Pediatric dose: not established Contraindication : hypersensitivity Pregnancy : fetal risk in some study in animals
Reference: Mukherje, S and Otah, E. 2008. Ileus. Downloaded at emedicine.com September 2008