Intestinal Complications and How to Cope

Abstract

After any abdominal operation there follows a period during which bowel activity is at a minimum and bowel sounds cease. The mechanism of this intestinal inhibition is sympathetic overactivity stimulated by manipulation of the bowel during surgery. This adynamic period is transient and lasts for about 24 h after which time intestinal activity and bowel sounds return. During this period of transient ileus it is sensible to avoid feeding the patient and to restrict the oral intake of fluid. Although bowel sounds return after 24 h, the normal propulsive action of the intestine takes a little longer and it is not unusual for the passage of rectal flatus to be delayed for 2–3 days. The first stool is passed a few days later and is usually liquid or loose in consistency, probably a result of fluid accumulation in the bowel during the adynamic phase. These “milestones” are brought forward if the patient receives a rectal suppository or an enema.