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 .
The effect of erythromycin on gastrointestinal motility in subtotal gastrectomized patients
Purpose Our objective was to determine the effect of erythromycin ( EM ) in improving gastrointestinal motility in subtotal gastrectomized patients . We used radio-opaque Kolomarks as an objective method . We conducted a prospect i ve , controlled clinical trial study of 24 patients . Methods All patients underwent subtotal gastrectomy with 3 capsules containing Kolomarks ( 20 markers per 1 capsule ) in the remnant stomach before anastomosis . From the day of the operation to the 2nd postoperative day , patients in the EM group began receiving 200 mg of EM intravenously for 30 minutes continuously . We counted the number of Kolomarks in the stomach , passed by stomach , in rectum , and in stool with serial simple abdominal X-ray films on the first postoperative day up to the 7th postoperative day . Results The study population included 14 patients in the control group and 10 patients in the EM group . The two study groups were compared in terms of their characteristics including age , gender , past medical history , cancer stage , and operation type . No significant differences were found for the demographics between the two groups . We only found a significant difference for the number of Kolomarks passed by the stomach on the 3rd postoperative day ( P = 0.026 ) . Conclusion Our results demonstrated that 200 mg of EM intravenous infusion during the postoperative period induced rapid gastric emptying , although it did not improve gastrointestinal motility for the entire gastrointestinal tract in subtotal gastrectomized patients
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 .