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Facilitating early recovery of bowel motility after colorectal surgery: a systematic review
Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Gastroentorology.
2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 1-2, 24-44 p.Article, review/survey (Refereed) Published
Abstract [en]


To determine how restored gastrointestinal motility can be accelerated after colorectal surgery.


Regaining normal bowel functions after surgery is described as unexpectedly problematic. Postoperative ileus is expected after all surgery where the peritoneum is entered, and the length of surgery has little or no impact in terms of the duration of Postoperative ileus. There is some speculation about the best way to facilitate bowel motility after colorectal surgery.


A systematic review.


The computerised databases Medline, Scopus and CINAHL were searched to locate randomised, controlled trials by using the following keywords: colorectal surgery, postoperative ileus, recovery of function and gastrointestinal motility. The systematic search was limited to studies published between January 2002-January 2012. Reference lists were also searched manually.


A total of 34 randomised, controlled trials were included in the review. Recovery of gastrointestinal motility was accelerated when one of the following forms of treatment was administered: probiotics, early feeding in combination with multimodal regimens, pentoxifylline, flurbiprofen, valdecoxib, ketorolac, clonidine, ropivacaine, lidocaine or spinal analgesia. Gum chewing, preoperative carbohydrate loading, bisacodyl and Doppler-guided fluid management have an uncertain effect on bowel motility. The use of nonpharmacological interventions, intrathecal morphine, restricted fluid therapy and choline citrate yielded no significant acceleration in bowel motility.


A multimodal treatment, where the use of morphine is restricted, seems to be the best way to accelerate the recovery of gastrointestinal bowel motility. However, more studies are required to optimise the multimodal protocol.


The early return of bowel functions leads to quicker overall postoperative recovery, which may ease patient discomfort and decrease hospitalisation costs.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014. Vol. 23, no 1-2, 24-44 p.
Keyword [en]
colorectal surgery, enhanced recovery, gastrointestinal motility, multimodal treatment, postoperative care
National Category
Clinical Medicine Nursing
URN: urn:nbn:se:liu:diva-102971DOI: 10.1111/jocn.12258ISI: 000327883400004PubMedID: 23786567OAI: diva2:685648
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2015-03-25Bibliographically approved

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Hollman Frisman, Gunilla
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Department of Surgery in LinköpingDivision of Nursing ScienceFaculty of Health SciencesDepartment of Gastroentorology
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