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A temporary arrest of intestinal peristalsis. It occurs most commonly after abdominal surgery, particularly when the intestines have been manipulated. Diagnosis is based on x-ray findings and clinical impression. (Symptoms) • constipation, flatulence • abdominal pain and discomfort • nausea, vomiting, belching (Causes) • Bowel obstruction. - Mechanical obstruction. - Without mechanical obstruction: Ogilvie's syndrome (acute colonic pseudo-obstruction). - Intraperitoneal or retroperitoneal inflammation (e.g. appendicitis, diverticulitis, perforated duodenal ulcer) • Intestinal paralysis: Caused by inhibitory neural reflexes, inflammation, or neurohumoral peptides. - Abdominal surgery (postsurgical ileus). - Drugs (e.g. opioids, anticholinergics, sometimes calcium channel blockers) - Metabolic disturbances (e.g. hypokalemia, hypercalcemia): Due to reduced neural conduction to and within enteric nervous system. - Spinal cord injury: Especially in the upper thoracic and cervical levels of the cord. (Risk factors) • hypothyroidism • diabetes • acute intermittent porphyria: A rare metabolic disorder affecting the production of heme resulting from a deficiency of the porphobilinogen deaminase. etc. (Diagnosis) • Stethoscope: Normal sounds like clicks and gurgles are ok. No sound can be a sign. • Imaging (e.g. X-rays, CT scan, gastrointestinal series). (Treatment) If the causes are known, correct them. • Nothing by mouth. • Enteral feeding tube. If the motility is completely disrupted, nasogastric suction and parenteral nutrition may be required until passage is restored. • Chewing gum (sham feeding) • Stimulation of bowel movements: lactulose, erythromycin, neostigmine (in severe cases due to neurological component) • Discontinue or reduce drugs which cause the disease. • Intravenous fluid to correct any electrolyte imbalance. • Electrical stimulation to encourage intestinal movement. • Upright position (especially after spending a lot of time lying down). • Surgery.