Neither metoclopramide nor erythromycin were effective in expediting the resolution of ileus .
Analyses of 32 r and omized controlled trials showed that EEN facilitates return of normal bowel function , achieving enteral nutrition goals , and reducing hospital length of stay .
CONCLUSION In patients who have undergone abdominal surgery , we strongly recommend EEN to expedite resolution of Ileus , but we can not recommend for or against the use of either metoclopramide or erythromycin to hasten the resolution of ileus in these patients .
BACKGROUND Ileus is a common challenge in adult surgical patients with estimated incidence to be 17 % to 80 % .
The main mechanisms of the postoperative ileus pathophysiology are fluid overload , exogenous opioids , neurohormonal dysfunction , gastrointestinal stretch , and inflammation .
Management includes addressing the underlying cause and supportive care .
Multiple medical interventions have been proposed , but effectiveness is uncertain .
A working group of the Eastern Association for the Surgery of Trauma aim ed to evaluate the effectiveness of metoclopramide , erythromycin , and early enteral nutrition ( EEN ) on ileus in adult surgical patients and to develop recommendations applicable in a daily clinical practice .
Metoclopramide role in preventing ileus after cesarean, a clinical trial
Purpose Ileus is a common event following cesarean section . Early post-cesarean recovery is very important not only for the mother but also for the baby who is dependent on breastfeeding . This article aims to demonstrate the efficacy of metoclopramide for the prevention of ileus after cesarean . Methods In this r and omized controlled trial , 696 women scheduled for cesarean were r and omized in two groups . Three hundred fifty-three persons settled in control group and 343 were assigned in intervention group who received an injection of 10-mg intramuscular metoclopramide  prior to operation . After cesarean , the participants recorded the first flatus , defecation , feeling of hunger , feeding and ambulation in a question naire , and also their sense of bloating in a visual analog scale under supervision of a research assistant . The data was analyzed by SPSS 17 , t test , and chi-square , while p < 0.05 was considered significant . Results The interval between cesarean and the first flatus ( p < 0.0001 ) , defecation ( p < 0.0001 ) , feeling of hunger ( p < 0.0001 ) , feeding ( p = 0.007 ) , and ambulation ( p < 0.0001 ) were significantly shorter in the metoclopramide group . In addition , polytomous logistic regression analysis showed the metoclopramide group had less bloating with significant difference ( OR = 2.83 and CI 1.91–4.21 ) . Conclusions Our study proved the functionality of metoclopramide in preventing ileus . As this drug is safe , tolerable , harmless , inexpensive and available , and also no definite method has been developed to prevent ileus after cesarean ; yet , metoclopramide could be considered as a suitable option . Certainly with regard to some limitations in our study , further comprehensive studies are still required to ensure validity of the obtained results
Neither metoclopramide nor erythromycin were effective in expediting the resolution of ileus .
Analyses of 32 r and omized controlled trials showed that EEN facilitates return of normal bowel function , achieving enteral nutrition goals , and reducing hospital length of stay .
CONCLUSION In patients who have undergone abdominal surgery , we strongly recommend EEN to expedite resolution of Ileus , but we can not recommend for or against the use of either metoclopramide or erythromycin to hasten the resolution of ileus in these patients .
BACKGROUND Ileus is a common challenge in adult surgical patients with estimated incidence to be 17 % to 80 % .
The main mechanisms of the postoperative ileus pathophysiology are fluid overload , exogenous opioids , neurohormonal dysfunction , gastrointestinal stretch , and inflammation .
Management includes addressing the underlying cause and supportive care .
Multiple medical interventions have been proposed , but effectiveness is uncertain .
A working group of the Eastern Association for the Surgery of Trauma aim ed to evaluate the effectiveness of metoclopramide , erythromycin , and early enteral nutrition ( EEN ) on ileus in adult surgical patients and to develop recommendations applicable in a daily clinical practice .