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 .
A randomised controlled trial of early initiation of oral feeding after cesarean section
Objective . To evaluate the safety and efficacy of early oral feeding after cesarean delivery . Methods . Two hundred women who had cesarean section were r and omly assigned to early feeding or routine feeding . Women in the early feeding group were encouraged to take sips of water 8 h post-operatively , followed by oral tea of 100 mL at the time of supervision . Women in the routine feeding group were managed by restricting oral intake for the first 24 h and administration of sips of water 24–48 h post-operatively . The outcome measures include the rate of ileus symptoms , post-operative time interval to presence of bowel sounds , passage of flatus and bowel movement , time interval to return to regular diet , length of hospital stay , post-operative complications , acceptability and benefit of early oral feeding  . Results . The early feeding group had a shorter mean post-operative time interval to bowel sounds 18.90 ± 4.17 h versus 36.21 ± 3.52 h ( p < 0.001 ) , passage of flatus 44.81 ± 3.73 h versus 60.58 ± 4.40 h ( p < 0.001 ) and bowel movement 58.30 ± 5.91 h versus 72.76 ± 4.25 h ( p < 0.001 ) . There was no significant difference in paralytic ileus symptoms . Early feeding group had a shorter mean hospital stay 4.80 ± 0.59 days versus 6.69 ± 0.71 days ( p = 0.001 ) . Early feeding group required less intravenous fluid 7.14 ± 1.34 bottles versus 11.8 ± 1.32 bottles ( p < 0.001 ) . Conclusions . Early feeding after cesarean section was well tolerated and safe and can be implemented without an increase in adverse outcome
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 .