Abstract: The present invention is directed to compositions useful in treating or preventing ileus in a patient. The compositions of the invention include a pituitary adenylate cyclase activating peptide (PACAP) receptor antagonist and/or a vasoactive intestinal peptide (VIP) receptor antagonist in an amount sufficient to treat or prevent ileus in a patient. In one embodiment both a PACAP and VIP receptor antagonists are present, preferably in a combination that blocks vasoactive pituitary cyclase 1 (VPAC1), VPAC2 and pituitary adenylate cyclase 1 (PAC1) receptors. Methods of using such composition to treat or prevent ileus in a patient are also encompassed by the invention.