# Paralytic ileus

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD99.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Postoperative Ileus - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK560780/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
PARALYTIC ILEUS
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD99.01 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Postoperative Ileus - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK560780/
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - Abdominal bloating builds up gradually, unlike the sudden onset typical of mechanical
      obstruction  [abdominal distension]
    - Pain tends to be diffuse and constant, without signs of peritoneal irritation
    - Nausea, vomiting, inability to pass gas and intolerance of food by mouth are typical  [nausea
      · vomiting]
  SIGNS - what you find (2)
    - The abdomen is distended and drum-like, with mild diffuse tenderness on exam
    - Bowel sounds are typically sparse or absent, unlike the hyperactive sounds heard early in
      mechanical obstruction
  TESTS (4)
    - Plain abdominal x-rays are usually the first imaging obtained
    - Films taken lying and standing may show dilated small-bowel loops, but with gas still reaching
      the colon and rectum and no clear transition point
    - An abdominal CT with oral and intravenous contrast helps pinpoint a transition point and
      exclude a tumour or abscess
    - Blood work looks for reversible triggers such as low potassium, plus a complete blood count
      and electrolyte panel
  IF NOT THIS - what else fits (3)
    - Unlike ileus, a postoperative obstruction often shows bowel function briefly returning before
      nausea, vomiting and pain flare back up
    - Severe pain, feculent vomiting, or rapidly worsening distension point toward obstruction
      rather than ileus
    - Intra-abdominal abscess and bowel perforation must also be excluded, since they may need an
      intervention
  Source  StatPearls "Ileus" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Absence of normal bowel peristalsis without mechanical obstruction, often postoperative
            or drug-induced, causing distension, vomiting, and constipation. Needs hospital
            admission for bowel rest, NG decompression, IV fluids, and correction of the underlying
            cause; GP's role is to advise nothing by mouth and arrange urgent referral. - Refer,
            with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Absence of normal bowel peristalsis without mechanical obstruction, often postoperative
            or drug-induced, causing distension, vomiting, and constipation. Needs hospital
            admission for bowel rest, NG decompression, IV fluids, and correction of the underlying
            cause; GP's role is to advise nothing by mouth and arrange urgent referral.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Severe pain, fever, or peritonism suggesting bowel ischemia or perforation,
            significant electrolyte derangement, or prolonged vomiting with dehydration.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

---

Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

[Privacy policy](/privacy)