International Journal of Colorectal Disease

, Volume 23, Issue 12, pp 1175–1183

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

  • U. Zingg
  • D. Miskovic
  • I. Pasternak
  • P. Meyer
  • C. T. Hamel
  • U. Metzger
Original Article

DOI: 10.1007/s00384-008-0536-7

Cite this article as:
Zingg, U., Miskovic, D., Pasternak, I. et al. Int J Colorectal Dis (2008) 23: 1175. doi:10.1007/s00384-008-0536-7

Abstract

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.

Keywords

Bisacodyl Colorectal resection Gastrointestinal recovery Postoperative ileus Colon-stimulating laxatives 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • U. Zingg
    • 1
    • 2
  • D. Miskovic
    • 1
  • I. Pasternak
    • 1
  • P. Meyer
    • 1
  • C. T. Hamel
    • 2
  • U. Metzger
    • 1
  1. 1.Department of SurgeryTriemli HospitalZurichSwitzerland
  2. 2.Department of SurgeryUniversity Hospital of BaselBaselSwitzerland

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