If I am reading your questions correctly, an "ilius" or often referred to as a "paralytic ilius" is very similar to a bowel obstruction in the type and intensity of pain.The symptoms also mimic an obstruction in that there is often no BM or passing of gas for several days, bloating and severe vomiting. But unlike an obstruction, where there is an actual blockage of the bowel by adhesions wrapped around it or the inability for air and stool to move through, it is the part of the bowel itself, referred to as the ilius that simply stops functioning. It literally becomes paralyzed. There is No peristaltic movement to help the food pass through and allow the gas to escape. When you have an "ilius" your bowels simply stop functioning. There is often a backup of stool into the stomach which is vomited out. The pain can be horrific and very similar to the pain of a complete obstruction. I am not sure what the actual reason is, but many surgeons blame the long term use of narcotics and opioids as well as adhesions and other chronic bowel diseases. The treatment for an ilius is medical rather than surgical, as would be with an obstruction. usually you are admitted to the hospital and an NG tube is inserted to suction out any stool and bile that is in the stomach, as well as to keep you from vomiting. You are also given IV fluids and pain meds and you are not given any food or liquids by mouth until peristaltic activity resumes. basically, they want the bowel to have complete rest and once it has rested for several hours to several days it simply begins functioning again and you feel 100% better and usually go home shortly afterwards. I have had 3 ilius episodes and no operations were required. Bed rest and the NG tube and pain meds was the extent of the treatment. An ilius can usually be seen on x-ray by a good radiologist.
Laparatomy is the more major of the two bowel procedures you are asking about. It involves an inscision (under general anesthesia) most often from the naval to the pubic bone or slightly above, for the express purpose of examining your entire bowel and pelvic region thoroughly. The surgeon manipulates every inch of your bowel and examines it for lumps and irregularities. If you still have your uterus and/or ovaries, all of these organs are examined carefully as well. If repair work is needed the surgeon has complete access to the entire abdominal region. The inscision can be as long as 12 inches and requires suturing or stapling afterwards. Because of the extent of the surgery you are usually kept in the hospital for 3-5 days. Post op pain is often more intense because of the inscision and healing process. Infection risk is greater because the abdominal cavity has been completely exposed to air.
A Laproscope or Laprascopy is different. The surgeon makes several tiny slits in your abdominal area. As few as one or two or sometimes four or more, depending upon what he needs to do. The inscision is only about a half an inch or less in length. Then he or she inserts the trocanter or scope, inflates you with carbon dioxide until your belly is roughly the size of a basketball, giving him complete ability to see inside a hollow belly and visualize all of your organs without having to open you up from stem to stern. If surgery is required, he can insert his surgical instruments through the scope opening and operate under microsurgical techniques. Afterwards, the carbon dioxide is removed from your belly and with a few quick sutures, you are closed and the operation is over. Most usually you go home the same day after you have fully awakened from anesthesia and providing there is no medical or surgical problem.
This surgery is much easier to heal from and takes less time and causes less discomfort. But in the case of advanced or severe adhesions, many surgeons cannot perform a laprascopy because the adhesions get in the way of the tube insertions and the ability to visualize all of the belly is greatly reduced.
I hope this helps.
Hugs
Ginny
At Wed, 4 Jul 2001, marianne bolding wrote:
>
>What is an ileus, and what is the difference between a
>laparotomy and laproscopy? I had a laproscopy for an
>endo search and ended up with surgeory for an
>intestinal attachment to the ovary. Does that make it
>a laporatamy? I guess after I ate a bowl of clam
>chowder tonight. I got really sick, vomited, (butt on
>the can, head in the trash-graphic, but reality). That
>pain was the worst pain I've had since recupe. My
>insides still feel twisted when I walk, and the
>stitches really hurt, if I sneeze or cough. I really
>thought I was better. Now I'm a little worried...A
>rectal or intestinal problem? The ob is sending me to
>a gastroinologist. I just don't want it to be so soon
>after surgeory. But, I just can't believe I'm not
>farther along in the healing process. Does any of this
>sound like normal recupe to you. I will call my dr
>tomorrow. When I called Monday he said that he didn't
>touch my intestine, and that I shouldn't be having so
>many bowel problems, that the foods I ate sounded
>fine. He put me on a liquid diet then. I weigh 100lbs,
>and am very weak (I lost 10 lbs. 2 weeks before
>surgery from being sick). So, since I felt better and
>had a bowel movement I felt I could eat more solid
>foods, I want to get the weight up. Yet, it's futile
>if I have to play the milk of magnesia-pepto game. I
>use to poop every morning...those were the good ole
>days....funny, what we cling to now, huh?...nice to
>meet you. thanks for replying. We should all bond
>together and start petitioning our local (govt?) with
>letters and documents stating that this problem isn't
>so "rare & few", and to plead for better medical
>coverage for these issues (I'm lucky I have insurance,
>I didn't pay a dime. One woman at this site has to pay
>$1,00's of dollars for a lap), and for better medical
>awareness, compassion, and prescription drugs. Chronic
>pelvic pain is a disease...not a sickness. It's to
>have stomach pain that lasts longer than 6 months. It
>is as much a disease as chrone's, and demands the same
>respects. Love you all, after only 3 days on this
>site. I have a feeling that Lynda in AZ enjoyed some
>fireworks with her husband and children for the
>4th...I hope so...let us know...it'll make me feel
>good to picture the kids playing, people laughing, and
>you feeling good, too. (lynda, you have a beautiful
>way with words) Marianne
>--- toni welsh <twelsh1@hotmail.com> wrote:
>> At Wed, 4 Jul 2001, marianne bolding wrote:
>> >
>> >Well, it's the 4th. I'm going to explode in my
>> stomach
>> >if I can't make a "natural" bowel movement. It's
>> been
>> >6 days since my lap. w/surgeory to detach the
>> >intestine from the ovary (no prior surgeories), and
>> he
>> > had to turn the ovary around as the intestine
>> turned
>> >it upside down. My husband seems so bitter. I
>> vomited
>> >this morning and he came in to ask me if I knew
>> where
>> >his check stub was. He knows I got sick, I think
>> he's
>> >tired of it. I need to make a bowel movement
>> without
>> >going back and forth from milk of magnesia to pepto
>> >bismol. I only weigh 101 now. I've lost so much
>> wait
>> >with this. Any help out there? Marianne
>>
>> Marianne,
>> You should call the dr to see if he can help you, I
>> had an ileus after
>> the laparotomy the gyn did in 98 and he told me if
>> it did not resolve he
>> would have to take other measures, so I did what HE
>> said and that was to
>> drink as much HOT liquids that I could. I drank
>> alot of boullion broth
>> and then a cup of coffee. I hope maybe this might
>> help you !
>>
>> Love,
>> Toni
>>
>> http://www.adhesions.org/forums/listcmds.htm