Dietary Interventions for the Reduction of Postoperative Ileus Following Abdominal Surgery: A Literature Review

Abstract

Introduction: A postoperative ileus (POI) is a common complication in patients following abdominal surgery which slows patient recovery and increases postoperative morbidity, length of hospital stay, resource use and healthcare costs. Although many interventions have been hypothesized to play a role in the prevention and management of POI, including chewing gum, coffee, and early enteral feeding, current guidelines regarding best clinical practice are lacking. Objective: The aim of this study is to review the efficacy and safety of various dietary interventions used in the reduction of POI, to aid in providing evidence-based recommendations for future Canadian guidelines on this topic. Chewing gum, coffee, and early enteral feeding were examined. Methods: This literature review used the PubMed database. Fifteen articles were found to meet the inclusion criteria. The primary outcomes measured were the effectiveness of each intervention in lowering the incidence of an ileus as well as their overall safety. Results: Four of eight studies evaluated identified positive benefits from the addition of chewing gum on bowel recovery. Three primary studies identified that coffee is beneficial in reducing time to first bowel movement. Three of four studies showed that early enteral feeding significantly improves gastrointestinal motility. All studies reviewed agreed that their respective interventional measures are safe and are not associated with an increase in postoperative complications. Conclusion: Although none of the interventions reviewed show complete consensus regarding their ability to reduce POI, there is agreement that these measures are safe, well tolerated, and not related to any major adverse effects. Therefore, chewing gum, coffee, and early enteral feeding are all postoperative measures which patients can be encouraged to adopt. The exact combination of these methods which should be included in the guidelines is unknown and requires further studies to examine the additional benefits provided by using more than one intervention.