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 Versus “Traditional” Postoperative Feeding in Gynecologic Oncology Patients Undergoing Intestinal Resection: a Randomized Controlled Trial
Background A r and omized controlled trial was performed to assess the outcome of early oral postoperative feeding ( EOF ) compared with traditional oral feeding ( TOF ) in gynecologic oncology patients undergoing laparotomy with associated intestinal resection . Methods Patients aged 18–75 years , undergoing elective laparotomy , and with preoperative diagnosis of gynecologic malignancy , were eligible . Exclusion criteria included infectious conditions , intestinal obstruction , severe malnutrition , American Society of Anesthesiologists ( ASA ) score ≥4 , and postoperative stay in the intensive care unit lasting > 24 h. Patients allocated to EOF received liquid diet in the first postoperative day and then regular diet . Patients received traditional feeding scheme until resolution of postoperative ileus to start liquid diet . The primary end-point of the trial was length of hospital stay . Results Between January 1st , 2007 and March 15th , 2008 , 40 patients were r and omized to receive either EOF or TOF  . Hospital stay in patients who received EOF ( n = 18 ) was 6.9 days versus 9.1 days in the TOF group ( n = 22 ) ( P = 0.022 ) . Requirements for analgesic and antiemetic drugs , intensity of pain , intestinal function recovery , mean levels of postoperative satisfaction , postoperative complications , and quality -of-life scores did not differ between the two groups . Conclusion Early resumption of oral intake is feasible and safe in gynecologic oncology patients undergoing intestinal resection as part of a planned surgical procedure . Moreover , significant reduction in length of hospital stay was demonstrated
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 .