Early oral feeding should be resumed following the resolution of gastric ileus

The main aim of the study was to assess the feasibility of early mobilization and early feeding following the resolution of gastric ileus in patients who have elective open colonic surgery.

This was a randomized controlled trial of patients who were assigned to one of the following two groups. Group 1: patients were encouraged to mobilize postoperatively. A radiopaque marker was given orally on the first postoperative morning and X-ray film was taken daily until more than 70% of the markers had been emptied out of the stomach. Then patients received a diet regardless of flatus or defecation. Group 2: patients were not enforced to mobilize and allowed a diet following flatus or defecation.

No significant differences were noted in age, sex, and type of procedures in either group. No patient in group 1 vomited postoperatively, while postoperative time to oral diet was significantly shorter than that to the resumption of bowel function. No significant difference was seen in the incidence of complications. The time to first flatus in group 1 (median, 48 hours) was significantly shorter than that in group 2 (median, 67 hours). The length of hospitalization in group 1 (median, 7 days) was significantly shorter than that in group 2 (median, 10 days).

Early mobilization and early feeding following the resolution of gastric ileus is safe and feasible without vomiting in patients who have elective colonic surgery.