Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

• Published in: International journal of colorectal disease Vol. 23; no. 12; pp. 1175 - 1183
• Main Authors: Zingg, U., Miskovic, D., Pasternak, I., Meyer, P., Hamel, C. T., Metzger, U.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.12.2008; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bisacodyl - pharmacology; Cathartics - pharmacology; Colon - surgery; Double-Blind Method; Elective Surgical Procedures; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Motility - drug effects; Hepatology; Humans; Ileus - prevention & control; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - prevention & control; Postoperative Period; Proctology; Prospective Studies; Rectum - surgery; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Colorectal resection; Colon-stimulating laxatives; Gastrointestinal recovery; Postoperative ileus; Bisacodyl; Postoperative; Surgical resection; Laxative; Peristalsis; Gastrointestinal recovery . Postoperative ileus; Gastrointestinal; Recovery; Treatment; Gastroenterology; Rectum; Colon
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-008-0536-7

Background Postoperative ileus is a common condition after abdominal surgery. Many prokinetic drugs have been evaluated including osmotic laxatives. The data on colon-stimulating laxatives are scarce. This prospective, randomized, double-blind trial investigates the effect of the colon-stimulating laxative bisacodyl on postoperative ileus in elective colorectal resections. Materials and methods Between November 2004 and February 2007, 200 consecutive patients were randomly assigned to receive either bisacodyl or placebo. Primary endpoint was time to gastrointestinal recovery (mean time to first flatus passed, first defecation, and first solid food tolerated; GI-3). Secondary endpoints were incidence and duration of nasogastric tube reinsertion, incidence of vomiting, length of hospital stay, and visual analogue scores for pain, cramps, and nausea. Results One hundred sixty-nine patients were analyzed, and 31 patients discontinued the study. Groups were comparable in baseline demographics. Time to GI-3 was significantly shorter in the bisacodyl group (3.0 versus 3.7 days, P  = 0.007). Of the single parameters defining GI-3, there was a 1-day difference in time to defecation in favor to the bisacodyl group (3.0 versus 4.0 days, P  = 0.001), whereas no significant difference in time to first flatus or tolerance of solid food was seen. No significant difference in the secondary endpoints was seen. Morbidity and mortality did not differ between groups. Conclusion Bisacodyl accelerated gastrointestinal recovery and might be considered as part of multimodal recovery programs after colorectal surgery.