The treatment in certain cases of adynamic ileus still raises some problems in abdominal surgery. One of the symptoms of „maladie postoperatoire” is a decreased or lacking intestinal motility. Adynamia of the intestinal tract develops to a certain degree after all abdominal operations, since the operative trauma causes a temporary inhibition of the neuromuscular system. It is not only the operation itself, but also the characteristics of the postoperative condition that promote the development of intestinal adynamia. Such are bedrest wound pain, respiratory depression, as well as decreasing of diaphragmatic movement and intestinal wall tone . The analgetics are also decreasing the tone of the intestinal wall, irritability of nerves and the defecatory reflexes.
The motor function is gradually re-established in the different segments of the gastro-intestinal tract after surgery. Peristalsis of the small intestine returns within 24 hours, gastric motility within 48 hours, but paralysis of the colon may persist even for 3 to 5 days. It is often difficult to sharply differentiate between a still „phsiyological postoperative ileus” and an already persisting pathological hypofunction of the bowels. Around the third postoperative day, instead of the relief of gases and the appearance of hunger feeling, the patient is discomforted, distented, has no appetite. At the physical examination meteorism may be palpated and bowel sounds cannot be heard. To control adynamia, first the most simple methods are used, such as blind enema, clyster, or purgation. Obviously, in cases of severe postoperative ileus following abdominal surgery, sympatholytic treatment, as summarized by Petri, is the upto-date method of choice.
To enhance bowel movements we looked for a simple laxative which assures the first defecation after the operation relatively quickly, and without causing disagreeable complaints due to irritation of the intestinal wall, excessive peristalsis, severe colic or hypo-gastric hyperaemia.
The aperient „Hunyadi János”, a natural medicinal water being in use as laxative since 1863, was tried out at our department. This aperient water of Buda (part of Budapest, on the right bank of the Danube) containing sodium sulfate, magnesium sulfate and sodium cloride, finds its application in form of a drinking cure primarily in patients suffering from internal diseases such as chronic constipation, gallbladder and biliary duct diseases, certain cases of hepatopathies and chronic pancreatitis.A teljes cikk itt olvasható Additional entries