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 .
Early oral feeding in patients undergoing elective colonic anastomosis.
BACKGROUND This study assesses the safety outcome of early oral feeding and reports on the factors affecting early postoperative feeding after colorectal procedures . PATIENTS AND METHODS Between June 2005 and April 2008 , 120 consecutive patients underwent elective colonic anastomosis and were then r and omized into two groups . The early feeding group began fluids on the first postoperative day while the regular feeding group was managed in the traditional way - nothing by mouth until the resolution of ileus . RESULTS The majority of patients ( 75 % ) tolerated the early feeding . The times to first passage of flatus ( 3.3+/-0.9 days vs 4.2+/-1.2 days ) and stool ( 4.1+/-1.2 days vs 4.9+/-1.2 days ) were significantly quicker in group 1 . Hospital stay was also significantly shorter in the early feeding group ( 6.2+/-0.2 days vs 6.9+/-0.5 days ) . Operative time and amount of blood loss had an impact on the tolerability of early feeding while age , gender , type of operation and previous abdominal operation had no such impact . CONCLUSION Early oral feeding after colorectal surgery is safe and tolerated by the majority of patients . Operative time and amount of blood loss do , however , have an impact on the tolerability of early feeding
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 .