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

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, doubleblind trial investigates the effect of the colon-stimulating laxative bisacodyl on postoperative ileus in elective colorectal resections.

The Opioid Component of Delayed Gastrointestinal Recovery After Bowel Resection

“…Bisacodyl significantly decreased time to first BM (P=0.001) compared with placebo but provided no benefit on VAS pain scores, opioid consumption, nausea and vomiting, or hospital LOS. 60 These results suggest that bisacodyl may accelerate GI recovery after BR; however, it would still need to be combined with other agents to effectively mitigate other morphine-related side effects or to reduce opioid consumption.…”

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

“…Oral magnesium oxide was demonstrated to promote postoperative bowel function in a double-blinded RCT in abdominal hysterectomy [160] and in reports from a well-established enhanced recovery program in colonic resection [1,161]. Another randomised trial in liver resection showed that oral magnesium enhanced the return of bowel function [162] [164]. There was no effect of bisacodyl on tolerance to solid food or LOSH.…”

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

“…Artificial nutrition should be considered selectively in patients with DGE of long duration Evidence level Very low Recommendation grade Strong Stimulation of bowel movement There is no high-level evidence to support a specific motility-enhancing drug. A multimodal approach involving the use of oral laxatives such as magnesium sulphate or bisacodyl may induce early gastrointestinal transit after colonic resections [173,174]. Some protocols for fast-track pancreatic surgery have recommended the use of laxatives postoperatively [175].…”