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 .
Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection.
BACKGROUND & AIMS The evidence in support of Early Enteral Nutrition ( EEN )  after upper gastrointestinal surgery is inconclusive . The aim of this study was to determine if EEN improved clinical outcomes and shortened length of hospital stay . METHODS Open , prospect i ve multicentre r and omised controlled trial within a regional UK Cancer Network . One hundred and twenty-one patients with suspected operable upper gastrointestinal cancer ( 54 oesophageal , 38 gastric , 29 pancreatic ) were studied . Patients were r and omised to receive EEN ( n = 64 ) or Control management postoperatively ( nil by mouth and IV fluid , n = 57 ) . Analysis was based on intention-to-treat and the primary outcome measure was length of hospital stay . RESULTS Operative morbidity was less common after EEN ( 32.8 % ) than Control management ( 50.9 % , p = 0.044 ) , due to fewer wound infections ( p = 0.017 ) , chest infections ( p = 0.036 ) and anastomotic leaks ( p = 0.055 ) . Median length of hospital stay was 16 days ( IQ = 9 ) after EEN compared with 19 ( IQ = 11 ) days after Control management ( p = 0.023 ) . CONCLUSIONS EEN was associated with significantly shortened length of hospital stay and improved clinical outcomes . These findings reinforce the potential benefit of early oral nutrition in principle and as championed within enhanced recovery after surgery programmes , and such strategies deserve further research in the arena of upper GI surgery
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 .