Does Caffeine Enhance Bowel Recovery After Colorectal Surgery?
Status:
Completed
Trial end date:
2019-12-31
Target enrollment:
Participant gender:
Summary
Postoperative ileus is a frequently occurring surgical complication. It is defined as
temporary inhibition of propulsive bowel activity and is manifested by abdominal distention,
nausea, vomiting and diet intolerance. It may lead to a prolonged hospital stay,
hospital-acquired infections or complications that may require additional treatments (e.g.
analgesia, fluids, electrolyte replacement, nasogastric tube decompression), and as a result
increase medical costs.
Previous studies showed that postoperative coffee consumption shortens the time to first
bowel movement after colorectal resections. However, none could explain the mechanism by
which coffee stimulates intestinal motility and the determinant agent for this action is
still up for discussion (either caffeine or another coffee component).
Coffee has a negligible caloric content; It has a pH that varies from 5 to 6 (less acidity
than other beverages that have no similar effect on bowel motility) and it is hypotonic.
Therefore, it is highly unlikely that bowel motility is due to the physical properties of the
coffee. Much more likely, that one (or more) of the numerous phytochemicals of the coffee
bean are responsible for this effect, when the most obvious candidate seems to be caffeine.
However, as mentioned above, very little evidence exists that caffeine was responsible for
the observed effect on colonic function in previous studies.
The purpose of this single-centered, prospective, single blinded, randomized clinical trial
is to evaluate whether the use of caffeine in the post-operative period significantly reduces
the duration of postoperative ileus, and therefore, improves recovery and shorten the
hospital stay.
The study hypothesis is that post-operative use of caffeine will reduce time to recovery of
GI function (post-operative ileus) by at least 15 hours and thus reduce hospital length of
stay by at least 15 hours in patients undergoing elective colorectal operations.
50 patients due to undergo large bowel resection via laparotomy or laparoscopy will be
enrolled and randomized (1:1) to those who will receive caffeine (100 mg 3 times per day) and
those who will receive placebo (tap water) starting on the morning of postoperative day 1
after surgery until flatus will occur for the first time or to a maximal period time of 7
days, whichever comes earlier.