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Pharmacological Therapies for Bowel Dysfunction After Colorectal Cancer Surgery: A Systematic Review
Alimohammad Bananzadeh1,2, Seyed Matin Emami1,3, Seyed Mohammad Kazem Tadayon1,4
1Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Advanced Pharmaceutical Bulletin
|July 29, 2026
Summary
Pharmacological therapies show some promise for bowel dysfunction after colorectal cancer surgery, but evidence is limited. More rigorous trials are needed to confirm effectiveness and guide clinical practice for this common complication.
Area of Science:
- Gastroenterology
- Oncology
- Pharmacology
Background:
- Bowel dysfunction is a common and debilitating complication following sphincter-preserving surgery in colorectal cancer (CRC) patients.
- Effective management strategies for post-surgical bowel dysfunction are crucial for improving patient quality of life.
Purpose of the Study:
- To systematically review and evaluate the existing evidence on pharmacological therapies for bowel dysfunction in colorectal cancer patients post-surgery.
- To identify potential therapeutic options and highlight gaps in current research.
Main Methods:
- A systematic literature search was conducted in November 2024 across PubMed, Web of Science, and Scopus.
- Included studies were experimental or quasi-experimental, focusing on conventional pharmacological therapies and herbal medicine for post-surgical bowel dysfunction in CRC patients.
Main Results:
- Eight studies were eligible from 8,989 retrieved records.
- Investigated interventions included serotonin type 3 receptor antagonists, herbal medicines (Daikenchuto, modified Baizhu Shaoyao San), diazepam, Botulinum A toxin, and phenylephrine.
- Most interventions demonstrated varied improvements in stool frequency, incontinence, urgency, or quality of life, though most studies had a high risk of bias.
Conclusions:
- While some pharmacological interventions show potential for managing post-surgical bowel dysfunction in CRC patients, the current evidence base is insufficient.
- A significant evidence gap exists, necessitating large-scale, high-quality randomized controlled trials to establish definitive treatment guidelines.
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