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Home / Equine Research Bank / Front Vet Sci / Postoperative Ileus: Comparative Pathophysiology and Future ...
Frontiers in veterinary science2021; 8; 714800; doi: 10.3389/fvets.2021.714800

Postoperative Ileus: Comparative Pathophysiology and Future Therapies.

Abstract: Postoperative ileus (POI), a decrease in gastrointestinal motility after surgery, is an important problem facing human and veterinary patients. 37.5% of horses that develop POI following small intestinal (SI) resection will not survive to discharge. The two major components of POI pathophysiology are a neurogenic phase which is then propagated by an inflammatory phase. Perioperative care has been implicated, namely the use of opioid therapy, inappropriate fluid therapy and electrolyte imbalances. Current therapy for POI variably includes an early return to feeding to induce physiological motility, reducing the inflammatory response with agents such as non-steroidal anti-inflammatory drugs (NSAIDs), and use of prokinetic therapy such as lidocaine. However, optimal management of POI remains controversial. Further understanding of the roles of the gastrointestinal microbiota, intestinal barrier function, the post-surgical inflammatory response, as well as enteric glial cells, a component of the enteric nervous system, in modulating postoperative gastrointestinal motility and the pathogenesis of POI may provide future targets for prevention and/or therapy of POI.
Copyright © 2021 Hellstrom, Ziegler and Blikslager.
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Publication Date: 2021-09-13 PubMed ID: 34589533PubMed Central: PMC8473635DOI: 10.3389/fvets.2021.714800Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores postoperative ileus (POI), a condition characterized by reduced gastrointestinal movement after surgery. The study also maps out future therapies for this condition, while considering the roles of the gastrointestinal microbiota, inflammatory responses, and the function of the intestinal barrier.

Understanding Postoperative Ileus (POI)

  • Postoperative ileus (POI) is a condition characterized by a reduction or halt in gastrointestinal motility following surgery. This condition often has dire consequences for both human and veterinary patients, particularly horses where approximately 37.5% didn’t survive to discharge after developing POI following small intestinal resection.

Pathophysiology of POI

  • The study goes on to describe the two main components of POI pathophysiology, which include a neurogenic phase followed by an inflammatory phase.
  • Both these phases are further affected by perioperative care, specifically the use of opioid therapy, inappropriate fluid therapy and electrolyte imbalances.

Current POI Management and Therapy

  • Management and treatment of POI currently involve efforts to ensure early return to feeding in order to induce physiological motility.
  • Another aspect of intervention is the reduction of the inflammatory response through the administration of non-steroidal anti-inflammatory drugs (NSAIDs).
  • The use of prokinetic therapy, such as lidocaine, is another concurrent strategy. However, the best methods of managing POI remain a controversial topic due to varying results.

Future Therapies

  • Future therapies will consider a more inclusive understanding of the roles of the gastrointestinal microbiota, intestinal barrier function, and enteric glial cells, which are a component of the enteric nervous system.
  • Understanding these factors would provide a more comprehensive understanding of how gastrointestinal motility can be modulated post-surgery and how the pathogenesis of POI can be influenced.
  • This could ultimately lead to more effective prevention and treatment methods of POI in both human and veterinary medicine.

Cite This Article

APA
Hellstrom EA, Ziegler AL, Blikslager AT. (2021). Postoperative Ileus: Comparative Pathophysiology and Future Therapies. Front Vet Sci, 8, 714800. https://doi.org/10.3389/fvets.2021.714800

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 8
Pages: 714800

Researcher Affiliations

Hellstrom, Emily A
  • Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
Ziegler, Amanda L
  • Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
Blikslager, Anthony T
  • Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.

Grant Funding

  • P30 DK034987 / NIDDK NIH HHS
  • R01 HD095876 / NICHD NIH HHS

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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