Does disorder of gastrointestinal motility affect food intake in the post-surgical patient?
In summary, POI is a predictable event with actual return of bowel function preceding clinically detectable signs of function by at least 24 h. All parts of the gastrointestinal tract are affected, but small-intestinal function returns first, probably as early as 4-8 h after surgery in many cases. The timing of restarting feeding could be earlier than current practice would suggest, and because of the more rapid recovery of small-intestinal function it could be argued that post-pyloric feeding, at least in the first 24-48 h, may be preferable. While a policy of refeeding only when bowel function is clinically detectable is acceptable for many patients, there are certainly some who would benefit from feeding at an earlier stage. Parenteral feeding is expensive and a greater knowledge of the mechanisms underlying POI may lead clinicians to different and perhaps more appropriate methods of management.
Department of Gastroenterology and Nutrition, Central Middlesex Hospital, London.
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Bowling
D005502:Food; D005769:Gastrointestinal Motility; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D009747:Nutritional Physiological Phenomena; D011183:Postoperative Complications