Abstracts
1999 Digestive Disease Week

# 2207 EARLY POSTOPERATIVE FOOD INTAKE INDUCES COLONIC MOTILITY FOLLOWING COLORECTAL SURGERY IN PATIENTS
M E Kreis, Univ Hosp, Tuebingen Germany; G Thiers, Tilman T Zittel, M Kasparek, Univ Hosp Tuebingen, Tuebingen Germany; H D Becker, E C Jehle, Univ Hosp, Tuebingen Germany

Introduction: After colorectal surgery, inhibitiion of colonic motility occurs which impairs rapid patient recovery and may prolong hospital stay. Since reduced motility results in delayed transport of intestinal contents, patients are frequently restricted from oral food intake following abdominal surgery. However, oral food intake is a potent stimulus for colonic motility which has been described as the gastro-colonic reflex in normal volunteers. We, therefore, aimed to investigate whether early oral food intake may stimulate colonic motility via the gastro-colonic reflex in postoperative patients. Methods: 12 patients (10m, 2f; median age 58 years, range 40-64) were studied following colorectal surgery (sigmoid colon resection n = 7, anterior rectal resection n = 5). During surgery, a combined manometry/barostat catheter was placed transanally into the colon with the barostat bags and the manometry ports at minimum 10 cm orad to the anastomosis. On postoperative day 1 and 2, baseline colonic motility was recorded for 30 min (Dual Drive Barostat, G&J Electronics, Canada; perfusion manometry, Arndorfer, USA). Then, patients ingested a standard 200ml liquid meal (500 kcal; 53% fat, 12% protein, 35% carbohydrates) within 15 minutes. Recordings were continued during the meal and 60 minuts postpradially. No laxatives were given on day 1 and 2 after surgery. Motility recordings were analyzed by dedicated software. Data are given as a mean ± SEM. Results: On day 1 after surgery, the colonic motility index increased form 52 ± 31 at baseline to 96 ± 32 mmHg/min during the meal (p < 0.05) and 152 ± 55 postprandially (p < 0.05). In parallel, frequency and amplitude of colonic contractions increased during the meal and postprandially, while barostat bag volumes decreased. On day 2, the motility index at baseline was 219 ± 80 mmHg/min which was already higher than on day 1 (p < 0.05). There was no further increase on day 2, neither during the meal (259 ± 79, ns) nor postpradially (217 ± 53, ns). Frequency and amplitude of colonic contractions did not change following the meal on day 2 afger surgery. 7 patients had their 1st bowel movement on postoperative day 2, 2 patients on day 3, another 2 patients on day 4, and 1 patients on postoperative day 5. Conclusions: Oral food intake early after surgery seems to stimulate colonic motility. This should help to shorten postoperative ileus leading to rapid overall recovery from colorectal surgery.

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