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Updated: Apr 15, 2026
Postoperative Ileus Murine Model
Published on: July 12, 2024
Postoperative ileus: Recent developments in pathophysiology and management
Damian Bragg1, Ahmed M El-Sharkawy1, Emmanouil Psaltis1
1Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Insights
Postoperative ileus (POI) is a common surgical complication. Strategies like epidural analgesia and fluid management can prevent POI, though treatment for prolonged cases needs more research.
Area of Science:
- Gastroenterology
- Surgical Complications
- Clinical Review
Background:
- Postoperative ileus (POI) frequently complicates surgery, leading to increased morbidity and healthcare costs.
- Understanding POI's classification, pathophysiology, and management is crucial for patient recovery.
Purpose of the Study:
- To provide an updated review of classification systems for POI.
- To summarize current knowledge on POI's preventive techniques, pathophysiological mechanisms, and treatment options.
Main Methods:
- A narrative review of studies published from January 1997 to August 2014.
- Searches conducted across Web of Science, MEDLINE, PubMed, and Google Scholar using keywords like 'ileus' and 'postoperative ileus'.
Main Results:
- Key pathophysiological mechanisms include fluid overload, opioids, neurohormonal dysfunction, and GI stretch/inflammation.
- Preventive measures include thoracic epidural analgesia, fluid management, alvimopan, gum chewing, minimal access surgery, and avoiding nasogastric tubes.
- Evidence for treating prolonged POI remains limited, necessitating further investigation.
Conclusions:
- While POI is often unavoidable, evolving methods aim to shorten its duration and improve gastrointestinal function recovery.
- Standardized diagnostic classification systems are essential for enhancing the applicability of future research on POI.
Background & Aims:
Postoperative ileus (POI) is a frequent occurrence after abdominal and other types of surgery, and is associated with significant morbidity and costs to health care providers. The aims of this narrative review were to provide an update of classification systems, preventive techniques, pathophysiological mechanisms, and treatment options for established POI.
Methods:
The Web of Science, MEDLINE, PubMed and Google Scholar databases were searched using the key phrases 'ileus', 'postoperative ileus' and 'definition', for relevant studies published in English from January 1997 to August 2014.
Results:
POI is still a problematic and frequent complication of surgery. Fluid overload, exogenous opioids, neurohormonal dysfunction, and gastrointestinal stretch and inflammation are key mechanisms in the pathophysiology of POI. Evidence is supportive of thoracic epidural analgesia, avoidance of salt and water overload, alvimopan and gum chewing as measures for the prevention of POI, and should be incorporated into perioperative care protocols. Minimal access surgery and avoidance of nasogastric tubes may also help. Novel strategies are emerging, but further studies are required for the treatment of prolonged POI, where evidence is still lacking.
Conclusions:
Although POI is often inevitable, methods to reduce its duration and facilitate recovery of postoperative gastrointestinal function are evolving rapidly. Utilisation of standardised diagnostic classification systems will help improve applicability of future studies.
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