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 .
Effect of early enteral feeding after upper gastrointestinal surgery.
BACKGROUND AND AIMS The impact of early enteral nutrition in elective upper gastrointestinal surgery was the focus of this study , with particular reference to its feasibility and benefits . METHOD This prospect i ve study was carried out over 2 years . The study group included 30 patients and the control group had 31 patients . Twenty-two patients in each group underwent truncal vagotomy and gastrojejunostomy for chronic duodenal ulcer and gastric outlet obstruction . Eight patients in the study group and nine in the control group underwent gastrectomy for carcinoma stomach .  A st and ard milk-based diet was initiated 12 hours after surgery through a nasojejunal tube . The patients were monitored for side effects of enteral feeding and postoperative infective complications . Nitrogen balance and nutritional parameters like the body weight , serum albumin , and serum transferrin were measured pre and postoperatively . RESULTS The groups were comparable with respect to age , sex , and preoperative nutritional factors like body weight , serum albumin , and serum transferrin . The return of bowel sounds and passage of flatus took place significantly earlier in the study group ( 1.43 vs. 2.81 days ) . Diarrhoea and abdominal cramps were the significant complications noted in the study group in relation to early enteral feeding . No patient required withdrawal of enteral feeds . They showed a positive nitrogen balance on the fourth postoperative day . The patients in the study group showed significant increase in the serum transferrin level compared with the preoperative level but the serum albumin level was not significantly altered . CONCLUSION Early enteral feeding through the nasojejunal tube following elective upper gastrointestinal surgery is feasible , safe and improves the nutritional status
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 .