Postoperative ileus (POI) refers to the period of gut dysmotility that occurs after abdominal
surgery. Patients with POI are unable to eat, suffer ongoing nausea and vomiting, are unable
to open their bowels and have a prolonged hospital stay. Research at ADHB shows that 25% of
patients will have a prolonged POI after elective bowel resection, which makes it the most
common major complication after colorectal surgery. Clinicians currently lack a definitive
medication to prevent or treat POI, which means POI causes patients ongoing morbidity and
places a significant drain on healthcare resources. Serotonin plays an important role in gut
motility. Evidence suggests that serotonin agonists, such as prucalopride, increase gut
transit and may have anti-inflammatory properties. The hypothesis of this study is that
Prucalopride given pre-operatively and continued post-operatively in patients having an
elective bowel resection will improve gut function recovery after surgery and reduce POI.
The investigators' proposed study is a double-blinded randomised controlled trial of
prucalopride compared to an identical placebo tablet, in patients having an elective bowel
resection at Auckland City Hospital. Patients will receive a single tablet of Prucalopride or
placebo 2-3 hours preoperatively and then daily after operation for a maximum of 6 days. The
primary endpoint will be return to bowel function defined by the time to tolerate a solid
diet and pass stool. In addition, the investigators plan to assess postoperative gastric
emptying rates using the safe and non-invasive carbon breath test method. This will allow the
investigators to determine the effects of prucalopride on the stomach, and support its role
as a gastric prokinetic.