Gastrografin in Prolonged Postoperative Ileus: A Double-blinded Randomized Controlled Trial

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Pharmacology

Background:

• Prolonged postoperative ileus (PPOI) is a common complication after colorectal surgery.
• Gut wall edema is a key factor in PPOI pathogenesis.
• Hyperosmotic agents like Gastrografin are theorized to reduce edema.

Purpose of the Study:

• To evaluate the efficacy of Gastrografin in reducing PPOI duration.
• To assess Gastrografin's impact on specific PPOI resolution markers.

Main Methods:

• A double-blinded, placebo-controlled, randomized trial.
• 100 mL Gastrografin versus flavored distilled water administered enterally.
• Standardized management and 12-hourly assessment of PPOI resolution.

Main Results:

• No significant difference in overall PPOI duration between Gastrografin and placebo groups (83.7 vs 101.3 hours).
• Gastrografin accelerated time to flatus/stool (18.9 vs 32.7 hours) and resolution of abdominal distension (52.8 vs 77.7 hours).
• No differences observed in nausea/vomiting, oral diet consumption, nasogastric output, or length of stay.

Conclusions:

• Gastrografin is not clinically effective for PPOI with combined upper and lower GI symptoms.
• Potential therapeutic benefit for PPOI patients with isolated lower GI symptoms post-surgery.