Postoperative Ileus Clinical Trial
Official title:
Does Coffee Consumption Prevent or Shorten Postoperative Ileus After Colon Resection? A Prospective Randomized Clinical Trial
The purpose of this study is to determine if consuming an 8 ounce cup of coffee with breakfast and lunch is effective in preventing or reducing postoperative ileus.
Recent evidence has shown that a multimodal rehabilitation program can accelerate recovery
of GI function after colon resection. 8 A multicenter, randomized, placebo-controlled,
double-blind, phase 3 trial demonstrated that Alvimopan, a peripherally acting mu-opioid
receptor antagonist, appears to accelerate GI tract recovery by 1 day, and reduces
postoperative ileus-related morbidity without compromising opioid analgesia. 9 Asao et al
demonstrated that gum chewing can accelerate recovery of GI function, also by 1 day, after
abdominal surgery. 10 Epidural anesthesia has been shown to shorten duration of POI, as well
as improve pain control, decrease pulmonary complications, and quicken recovery times.
However, it does not appear to reduce overall length of stay. 4 However, Neudecker et al.
were unable to reproduce the results of previous trials evaluating the effect of thoracic
epidural analgesia on duration of postoperative ileus following laparoscopic sigmoid
resection. 11 Given conflicting data, no one single measure has been adopted for the
prevention POI.
Recent evidence has shown that coffee may be a stimulant for the GI Tract. A small study of
16 healthy volunteers demonstrated that coffee appears to increase rectal tone thus implying
an impact on defecation mechanics.12 Furthermore, several studies have demonstrated
caffeinated coffee to be a stimulant of motor activity in the colon.13,14 Given its
potential pro-motility properties in the GI tract, it seems reasonable to postulate that
coffee, a commonly consumed product by the general public, may play a role in shortening and
possibly preventing POI. This directly impacts overall patient satisfaction but will reduce
length of stay and overall hospital costs.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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