My sister has not passed stool for 3 days post-C-section. Why?

Hello,

Welcome to icliniq.com.

I am deeply concerned about your worries.

Most likely, the condition is caused by paralytic ileus. Paralytic ileus occurs in the intestines, the long, tube-like passageway where food is broken down and absorbed before the waste is expelled as stool. The intestines normally process food through a series of wave-like movements called peristalsis.

Paralytic ileus is the paralysis of these movements. This means the muscles or nerve signals that trigger peristalsis have stopped working, preventing the normal movement of food through the intestines. As a result, stagnant food, gas, and fluids accumulate in the intestines, which may cause symptoms such as bloating, abdominal distension, constipation, and nausea.

Paralytic ileus is an acute condition, meaning it is temporary and reversible once the underlying cause is addressed. Surgery is the most common cause of paralytic ileus. Please do not worry, I assure you that the symptoms will subside and the patient will recover.

Could you let me know if there is any history of abdominal bloating or gas? Has the patient passed stool or flatus?

1. I would advise you to perform certain investigations. If these have already been done, please share the reports with me. CBC (complete blood count).
2. LFTs (liver function tests).
3. RFTs (renal function tests).
4. Serum electrolytes.
5. RBS (random blood sugar).
6. Ultrasound of abdomen and pelvis.

Management includes:

1. Keep the patient NPO (nothing by mouth).
2. Injection Zinocef 750 mg (Cefuroxime) intravenous twice daily.
3. Injection Flagyl 500 mg (Metronidazole) intravenous thrice daily.
4. Injection R/L (Ringer’s lactate solution) with 2 KCl (potassium chloride) once a day.
5. Injection N/S (normal saline) with 2 KCl once a day.
6. Injection Risek 40 mg (Omeprazole) intravenous once a day.
7. Injection Ondansetron 8 mg intravenous twice daily.

Consult your specialist doctor, discuss with them, and take the medicines with their consent.

After keeping the patient NPO and starting IV medications, her condition should improve, and the symptoms should resolve. Please do not worry, she will recover.

Please feel free to reach out at any time if you have questions or need guidance. I am always here to support you.

Thank you

Hello,

Welcome back to icliniq.com.

I appreciate your quick response. Please share the investigations she has undergone so we can determine the possible cause of her condition.

Please do not worry.

I hope she will recover soon.

Kind regards.

Hello,

Welcome back to icliniq.com.

I have tried to open the file you sent me; however, there seems to be an issue. Each time I attempt to open it, the system automatically redirects me back to the login page. I have tried multiple times, but was unable to access it.

I would greatly appreciate it if you could kindly resend the file.

Thank you.

Hello,

Welcome back to icliniq.com.

I have reviewed all the reports, and they are normal except for the CBC, which shows a high TLC (total leukocyte count) of 17.8 and a low hemoglobin level of 9.2 g/dl, indicating mild anemia. The rest of the tests are within normal limits.

As I mentioned earlier, this is most likely paralytic ileus. The ultrasound impression also indicates paralytic ileus, which is a common condition following surgery. Please do not worry, I assure you that your sister will recover. She just needs to remain NPO (nothing by mouth) and receive the following medications. Within two days, her condition should improve.

Please continue with the IV medications mentioned previously. Once the vomiting has settled, oral medications can be started, which include:

1. Tablet Zinocef 750 mg (Cefuroxime) twice daily.
2. Tablet Flagyl 400 mg (Metronidazole) thrice daily.
3. Tablet Risek 40 mg (Omeprazole) once daily.
4. Tablet Iron Plus (Iron with Folic acid) once daily for three months to treat mild anemia.

For reference, the normal hemoglobin level should be above 10.5 g/dl.

1. Mild anemia: 10.5 to 9 g/dl.
2. Moderate anemia: 9 to 7 g/dl.
3. Severe anemia: 7 to 4 g/dl.
4. Very severe anemia: Less than 4 g/dl.

Please do not worry. I will closely follow up on your sister’s condition, and you are welcome to update me at any time.

Thank you.