Mechanisms of postoperative ileus

Bauer, A. J.; Boeckxstaens, G. E.

doi:10.1111/j.1743-3150.2004.00558.x

Cited by 377Gastrointestinal motility and disordersEnhanced Recovery After SurgeryIntestinal and Peritoneal Adhesions

Mechanisms of postoperative ileus

Bauer, A. J., Boeckxstaens, G. E.·2004·Neurogastroenterology & Motility

DOI 10.1111/j.1743-3150.2004.00558.x

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Abstract

Postoperative ileus is an iatrogenic condition that follows abdominal surgery. Three main mechanisms are involved in its causation, namely neurogenic, inflammatory and pharmacological mechanisms. In the acute postoperative phase, mainly spinal and supraspinal adrenergic and non‐adrenergic pathways are activated. Recent studies, however, show that the prolonged phase of postoperative ileus is caused by an enteric molecular inflammatory response and the subsequent recruitment of leucocytes into the muscularis of the intestinal segments manipulated during surgery. This inflammation impairs local neuromuscular function and activates neurogenic inhibitory pathways, inhibiting motility of the entire gastrointestinal tract. The mechanisms underlying the recruitment of the inflammatory cells, and their interaction with the intestinal afferent innervation, are discussed. Finally, opioids administered for postoperative pain control also contribute to a large extent to the reduction in propulsive gastrointestinal motility observed after abdominal surgery.

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The pathogenesis of ileus is mediated by overproduction of cytokines in the bowel, which interferes with smooth muscle function.
“The pathogenesis of ileus, a complication of abdominal surgery or trauma characterized by gastrointestinal hypomotility and delayed gastric emptying, is mediated by the overproduction of cytokines in the bowel, which interferes with smooth muscle function (48,49).”
From Physiology and immunology of the cholinergic antiinflammatory pathway (2007) · cites this paper as [49]

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Authors: Bauer, A. J., & Boeckxstaens, G. E.
Affiliations: University of Pittsburgh (US)
Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author: Bauer, A. J.
ORCID: Bauer, A. J.
Boeckxstaens, G. E.
Venue: Neurogastroenterology & Motility
Publisher: Wiley
Published: 2004-09-08
Volume: 16
Issue: s2
Pages: 54-60
ISSN: 1350-1925 (ISSN-L)
1365-2982
DOI: 10.1111/j.1743-3150.2004.00558.x
OpenAlex: W2117631084
Cited by: 377
References: 72
Citations by year: 2026: 11 · 2025: 13 · 2024: 17 · 2023: 14 · 2022: 17 · 2021: 21 · 2020: 10 · 2019: 18 · 2018: 14 · 2017: 18 · 2016: 17 · 2015: 17 · 2014: 17 · 2013: 20 · 2012: 24
FWCI: 2.63
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Neurogastroenterology & Motility (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
Keywords: postoperative ileus, abdominal surgery, neurogenic mechanisms, inflammatory mechanisms, pharmacological mechanisms, adrenergic pathways, intestinal inflammation, leukocyte recruitment, gastrointestinal motility, opioids, postoperative pain
MeSH terms: Analgesics, Opioid, Animals, Humans, Postoperative Complications, Digestive System Surgical Procedures, Ileus

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Mechanisms of postoperative ileus

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