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Word of the Day

Coffee prevents ileus after scheduled colectomy

Clinical Question:
Does coffee prevent postoperative ileus in patients undergoing scheduled colectomy?

Bottom Line:
In patients undergoing scheduled colectomy, consuming coffee starting the first day after surgery decreases the time to first bowel movement and does not appear to increase the rate of complications. (LOE = 2b-)

Reference:
Müller SA, Rahbari NN, Schneider F, et al. Randomized clinical trial on the effect of coffee on postoperative ileus following elective colectomy. Br J Surg 2012;99(11):1530-1538.  [PMID:22987303]

Study Design:
Randomized controlled trial (nonblinded)

Funding:
Unknown/not stated

Allocation:
Concealed

Setting:
Inpatient (any location)

Synopsis:
Many adults consume coffee in the morning to facilitate having a bowel movement, so it should come as no surprise that someone has decided to see if it has a therapeutic effect in clinical settings. The authors randomly assigned adults scheduled for colonic resection to receive 100 mL coffee (n = 40) or warm water (n = 40) 3 times daily starting the first morning after surgery. Additionally, the operative and postoperative care was standardized for both groups. All patients were offered water 6 hours after surgery, liquid food the first day after surgery, and solid food the second day. Approximately half the patients had cancers. The main outcome, time to first postoperative bowel movement, was 60 hours for coffee drinkers compared with 74 hours for control patients. Hospital length of stay and complications were comparable between the 2 groups. I am not sure what half a day difference in time to defecation means, but perhaps the main point is that there is no need to restrict coffee drinkers from enjoying their first cup of the day, even after having a surgeon muck around in their innards. Since this study took place in German hospitals, it is possible that weaker American coffee may not be as effective.

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