The natural course of postoperative ileus following abdominal surgery

Postoperative ileus is a normal, transient condition following surgical procedures of the abdomen. The restoration of gastrointestinal motility was studied in 50 patients who had abdominal surgery. The motility was evaluated by means of physical signs and clinical symptoms. Physical signs, such as bowel sounds, passage of first flatus and defecation, occurred on relatively constant moments in the postoperative period and did not depend on the type of operation. In the patients who had rectopexy, flatus and defecation passed significantly later, probably due to existing defecation problems before the operation. The moment of resumption of a normal diet varied greatly. None of the physical signs had a predictive value with regard to postoperative nausea or vomiting. No relation could be demonstrated between the moment of removal of the nasogastric tube and the volume of gastric aspirate drained by the tube. The period of postoperative drainage of the stomach in comparable patient groups differed strongly from ward to ward. More attention for nasogastric tube management following abdominal surgery seems desirable. Early removal of the tube is possible in most patients and diminishes unnecessary discomfort.