Postoperative Ileus Market to Advance Moderately During the Forecast Period (2025–2034) Owing to t

Author : k kumar | Published On : 04 Aug 2026

The postoperative ileus market is projected to experience consistent growth, supported by the increasing number of abdominal and gastrointestinal surgeries globally. Greater implementation of enhanced recovery after surgery (ERAS) protocols and the growing preference for minimally invasive procedures are further strengthening market expansion. Moreover, the anticipated introduction of pipeline therapies such as ORE-001 (Orexa BV), TU-100 (Tsumura USA), and others is expected to create additional growth opportunities.

DelveInsight’s Postoperative Ileus Market Insights report delivers an in-depth evaluation of current treatment approaches, postoperative ileus emerging drugs, therapy-wise market share, and both historical and forecasted market size from 2020 to 2034 across major markets (the US, EU4, UK, and Japan).

Postoperative Ileus Market Summary

• The postoperative ileus market size across the leading markets [the United States, the EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan] was estimated at USD 3.7 billion in 2024.

• The United States represented the dominant share of the postoperative ileus treatment market, accounting for nearly 95% of the total 7MM market size in 2024, compared to the EU4 countries, the United Kingdom, and Japan.

• In 2024, the United States reported approximately 379,500 incident cases of postoperative ileus.

• Prominent companies, including Orexa BV and Tsumura USA, are actively advancing novel therapies that could enter the postoperative ileus market in the coming years.

• Key pipeline candidates such as ORE-001 and TU-100 are currently undergoing clinical evaluation.

• According to DelveInsight’s projections, anti-emetics are anticipated to generate the highest revenue among therapy classes in the 7MM by 2034.

Discover the postoperative ileus new treatment @ New Treatments for Postoperative Ileus

Key Factors Driving the Growth of the Postoperative Ileus Market

High Clinical and Economic Burden of Postoperative Ileus

Postoperative ileus significantly prolongs hospital stays, increases readmission rates, and elevates overall healthcare expenditure following abdominal and colorectal surgeries. This economic strain creates a strong incentive for healthcare systems to adopt therapies and care pathways that facilitate faster gastrointestinal recovery.

Rising Volume of Surgeries and Higher-risk Patient Populations

An increase in both elective and emergency abdominal procedures—driven by aging demographics, growing cancer surgery volumes, and broader access to surgical services—continues to enlarge the at-risk population for POI, thereby expanding the addressable market.

Launch of Emerging Postoperative Ileus Therapies

Although the postoperative ileus pipeline remains relatively limited, promising mid-stage candidates such as ORE-001 (lidocaine) and TU-100 (Daikenchuto/TJ-100) in Phase II trials reflect ongoing innovation efforts. However, the overall therapeutic landscape continues to demonstrate measured progress with constrained competition.

Postoperative Ileus Market Analysis

Over the past two decades, the treatment landscape for postoperative ileus has witnessed minimal breakthrough innovation. Previously, alvimopan (ENTEREG), a peripherally acting µ-opioid receptor antagonist (PAMORA), was the sole FDA-approved therapy intended to accelerate gastrointestinal recovery after bowel resection surgery. Following its discontinuation as a branded product, management strategies now rely primarily on generics and supportive care measures.

Current therapeutic approaches include prokinetic agents such as metoclopramide, though their usage is limited due to safety concerns; NSAIDs and opioids; centrally acting opioid antagonists like naloxone, which may compromise analgesia; and peripheral opioid antagonists (PAMORAs) such as alvimopan and methylnaltrexone that target opioid-induced gastrointestinal dysfunction. Antiemetics help control nausea but do not directly address motility issues, while laxatives provide general symptomatic support. Intravenous lidocaine is sometimes utilized as an adjunct therapy to reduce opioid consumption and potentially enhance bowel function recovery.

With the absence of active branded therapies, the postoperative ileus treatment landscape remains narrow, focusing largely on mitigating impaired gastrointestinal motility and opioid-related effects. Encouragingly, two Phase II candidates—ORE-001 (Orexa BV) and TU-100 (Tsumura)—are advancing with the aim of improving symptom management and overall clinical outcomes across major markets.

To know more about postoperative ileus treatment options, visit @ Approved Postoperative Ileus Drugs

Postoperative Ileus Competitive Landscape

Emerging therapies such as ORE-001 (Orexa BV), TU-100 (Tsumura USA), and others are under development to broaden the range of available treatment options.

ORE-001, developed by Orexa BV, is an oral lidocaine formulation designed to stimulate appetite and support recovery in conditions including postoperative ileus, anorexia, and malnutrition in elderly populations. The therapy is currently being evaluated in a Phase II clinical study (NCT05923086) to determine its potential in preventing postoperative ileus.

TU-100, developed by Tsumura, is a traditional Japanese herbal formulation being studied for its role in supporting recovery following abdominal surgery. It enhances intestinal motility through neural mechanisms by stimulating acetylcholine release via serotonergic receptor activation. Additionally, it demonstrates anti-inflammatory properties by reducing neutrophil and macrophage infiltration and improving intestinal blood circulation.

The expected introduction of these pipeline therapies has the potential to significantly influence the postoperative ileus market landscape. As clinical development progresses and regulatory milestones are achieved, these therapies could redefine standards of care while unlocking new commercial and innovation opportunities.

Tsumura & Co.

• Company Name & Country: Tsumura & Co. (Japan)

• Drug Candidate Name(s): TU-100 (also known as Daikenchuto / TJ-100)

• Clinical Trial Phase(s):

  • Phase II (eg. NCT04742907) — randomized, double-blind, placebo-controlled trial assessing safety and efficacy in postoperative ileus resolution after abdominal surgery.

• Mechanism of Action (MOA):

  • TU-100 is a traditional Japanese herbal medicine that stimulates gastrointestinal motility through activation of neural pathways (enhancing acetylcholine release via serotonergic receptors), and also exerts anti-inflammatory effects by reducing neutrophil and macrophage infiltration and improving intestinal blood flow.
     

• Latest News / Developments / Clinical Data:

  • In March 2024, TU-100 completed a Phase II clinical trial (NCT04742907) evaluating its effect on postoperative ileus.

  • By **July 2024, Tsumura announced completion of patient enrollment for a late Phase II trial of TU-100 involving approximately 402 participants.

  • TU-100 has been studied in multiple clinical settings and academic RCTs historically, showing acceleration of GI recovery post-surgery and may be well tolerated with minimal safety concerns as collected in peer-reviewed outcomes and protocol documents.

• Clinical Trial Registry IDs:

  • NCT04742907 — Safety and Efficacy Study of TU-100 for Postoperative Ileus (Phase II)

Indirect/Collaborative

Although not corporate sponsors per se, several Japan-based academic clinical studies involve traditional medicine for postoperative ileus — often with industry funding or support. These should be noted as part of the overall ecosystem:

Daikenchuto in Academic Clinical Trials

• Institutional Activity: Multiple multicenter randomized controlled Phase II trials evaluating Daikenchuto (TU-100) on postoperative bowel motility and prevention of paralytic ileus in abdominal surgery patients have been reported in Japan-led studies.
   

• MOA: As above, works via gastrointestinal neural modulation and inflammatory modulation pathways.

• Example Historical Trial:

  • A Phase II multicenter RCT (JAPAN-PD study) assessing Daikenchuto’s effect on postoperative bowel motility after pancreaticoduodenectomy, demonstrating shorter time to bowel function recovery vs placebo.

• Not Sponsored Directly by Biopharma: These studies are typically investigator-initiated (academic) and may not list industry as the primary sponsor, though they are historically funded or supported by Tsumura or related foundations. 

Discover more about therapy for postoperative ileus @ Postoperative Ileus Clinical Trials

What is Postoperative Ileus?

Postoperative ileus, also referred to as Postoperative Gastrointestinal Dysfunction (POGD) or paralytic ileus, is a temporary impairment of gastrointestinal motility that commonly occurs following surgical procedures, particularly abdominal operations. It presents with abdominal distension and intolerance to oral intake due to reduced bowel movement in the absence of mechanical obstruction. The condition may involve opportunistic pathogens under compromised immune conditions. Common contributing factors include abdominal or pelvic surgeries and the use of opioid analgesics or anesthesia.

Postoperative Ileus Epidemiology Segmentation

The epidemiology section of the report outlines historical data, current trends, and future projections of the postoperative ileus patient population across the leading markets. In 2024, gastrointestinal/abdominal procedures accounted for nearly 5.68 million cases, representing a larger share of the at-risk population compared to non-abdominal surgeries.

The postoperative ileus market report provides epidemiological insights for 2020–2034 across major markets, segmented as follows:

• Total Gastrointestinal/Abdominal Procedures (at-risk population for postoperative ileus)

• Total Incident Cases of Postoperative Ileus

• Severity-specific Cases of Postoperative Ileus

• Postoperative Ileus Prevention and Treatment Eligible Patient Population

 

Scope of the Postoperative Ileus Market Report

• Therapeutic Assessment: Current marketed and emerging postoperative ileus therapies

• Market Dynamics: Key forecast assumptions for emerging drugs and overall market outlook

• Competitive Intelligence Analysis: SWOT analysis and market entry strategies

• Unmet Needs, KOL perspectives, analyst insights, and market access and reimbursement analysis
   

Download the report to understand which factors are driving postoperative ileus therapeutics market trends @ Postoperative Ileus Market Trends

About DelveInsight

DelveInsight is a leading Business Consultant and Market Research firm focused exclusively on life sciences. It supports pharma companies by providing comprehensive end-to-end solutions to improve their performance. Get hassle-free access to all the healthcare and pharma market research reports through our subscription-based platform PharmDelve.

 

Contact Us
Kanishk Kumar
[email protected]

+14699457679
www.delveinsight.com