title: Mechanisms and treatment of postoperative ileus.
abstract: OBJECTIVE
  To review the pathogenesis and treatment of postoperative ileus.
  
  
  METHODS
  Data collected for this review were identified from a MEDLINE database search of the English-language literature. The exact indexing terms were "postoperative ileus," "treatment," "etiology," and "pathophysiology." Previous review articles and pertinent references from those articles were also used.
  
  
  METHODS
  All relevant studies were included. Only articles that were case presentations or that mentioned postoperative ileus in passing were excluded.
  
  
  RESULTS
  The pathogenesis of postoperative ileus is complex, with multiple factors contributing either simultaneously or at various times during the development of this entity. These factors include inhibitory effects of sympathetic input; release of hormones, neurotransmitters, and other mediators; an inflammatory reaction; and the effects of anesthetics and analgesics. Numerous treatments have been used to alleviate postoperative ileus without much success.
  
  
  CONCLUSIONS
  The etiology of postoperative ileus can best be described as multifactorial. A multimodality treatment approach should include limiting the administration of agents known to contribute to postoperative ileus (narcotics), using thoracic epidurals with local anesthetics when possible, and selectively applying nasogastric decompression.
authors.affiliation: University of California at Sanf Francisco-East Bay, Oakland, USA. LuckeyA@surgery.uscf.edu
authors.forename: Andrew
authors.initials: A
authors.lastname: Luckey
authors.forename: Edward
authors.initials: E
authors.lastname: Livingston
authors.forename: Yvette
authors.initials: Y
authors.lastname: Taché
mesh_terms: D000701:Analgesics, Opioid; D000758:Anesthesia; D001341:Autonomic Nervous System / Q000503:physiopathology; D005769:Gastrointestinal Motility; D006728:Hormones / Q000502:physiology; D006801:Humans; D007249:Inflammation; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D018377:Neurotransmitter Agents / Q000502:physiology; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*
chemical_list: D000701:Analgesics, Opioid; D006728:Hormones; D018377:Neurotransmitter Agents