Postoperative ileus—Immune mechanisms and potential therapeutic interventions

Abstract Background Postoperative ileus (POI) is a condition marked by a temporary suppression of gastrointestinal motility following abdominal surgery. The mechanism of POI encompasses various factors and is characterized by two phases: the early neurogenic phase involving both adrenergic and non‐adrenergic neural pathways; the later immune‐mediated phase is characterized by a sterile inflammatory response that lasts several days. Activation of muscularis macrophages triggers a sterile inflammatory process that results in dysfunction of the enteric nervous system (ENS) and a reversible inhibition of gastrointestinal motility. Purpose In this minireview, recent insights in the pathophysiological mechanisms underlying POI and potential new therapeutic strategies are described.