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 .
Efficacy of metoclopramide in postoperative ileus after exploratory laparotomy.
STUDY OBJECTIVE To assess the efficacy of metoclopramide for treatment of postoperative ileus in patients who underwent exploratory laparatomy .  DESIGN Prospect i ve observational study SETTING Surgical intensive care unit ( SICU ) . PATIENTS Thirty-two patients who underwent exploratory laparatomy INTERVENTION Sixteen patients received metoclopramide  , and 16 did not . The primary outcome was time to first postoperative bowel movement . Secondary end points were length of stay ( LOS ) in the SICU and total hospital LOS . MEASUREMENTS AND MAIN RESULTS The mean number of days to first bowel movement was nearly identical for both the treatment group and control group ( 4.8 vs 4.7 days , respectively , p=0.93 ) . Length of stay in the SICU was 8.3 days for the treatment group and 8.6 days for the control group ( p=0.89 ) , and total LOS was 18.0 and 20.1 days , respectively ( p=0.63 ) . CONCLUSION The time to first bowel movement was not significantly different between the treatment and control groups . Also , metoclopramide did not decrease LOS .  Metoclopramide does not have a role in the treatment of postoperative ileus
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 .