Gastrointestinal (GI) symptoms after surgery are common in surgical ICU patients and are not limited to patients undergoing abdominal surgery. In most cases GI function recovers after surgery, if systemic and local inflammation and perfusion improve, fluid resuscitation-induced gut oedema resolves and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner. The GI function is very difficult to monitor and is not included in currently available organ dysfunction scores widely used in the ICUs (e.g. the Sequential Organ Failure Assessment score - SOFA score). Careful risk evaluation followed by a structured complex assessment and timely management of GI symptoms should minimize the potentially severe consequences and thereby possibly improve outcome.

This module describes the common non-specific GI symptoms and syndromes and some less common specific surgery-related abdominal problems, addresses the identification of patients at risk, outlines the GI function monitoring possibilities, and gives suggestions for perioperative GI management.