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

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International Journal of Colorectal Disease Aims and scope Submit manuscript

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.

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Acknowledgments

The authors thank Dr. M. Asanger for pharmaceutical support and preparation of the capsules, Dr. K. Delport for assistance in preparing the manuscript in English, and Prof. D. Oertli, F.A.C.S., for critical review of the manuscript. The authors declare no financial support.

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Correspondence to U. Zingg.

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Zingg, U., Miskovic, D., Pasternak, I. et al. Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial. Int J Colorectal Dis 23, 1175–1183 (2008). https://doi.org/10.1007/s00384-008-0536-7

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  • DOI: https://doi.org/10.1007/s00384-008-0536-7

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