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PubMed · 16546494

Specific oral medications decrease the need for surgery in adhesive partial small-bowel obstruction.

Shyr-Chyr Chen·Chien-Chang Lee·Zui-Shen Yen·Geng-Shiau Lin·Wen-Jone Chen·Po-Huang Lee·Hong-Shiee Lai·Fang-Yue Lin·Wei-Jao Chen
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Abstract

BACKGROUND: Nothing by mouth (NPO) is the standard treatment for small-bowel obstruction. Whether oral medications should be prohibited during treatment of adhesive, partial small-bowel obstruction is unclear. The goal of this study was to determine whether a combination of specific oral medications in adhesive, partial small-bowel obstruction will decrease the need for operative intervention. METHODS: Of 266 consecutive adult patients with partial small-bowel obstruction admitted at a tertiary medical center, 236 were randomized into 2 groups. Group I patients were treated with intravenous hydration, nasogastric tube decompression, and NPO. Group II patients were placed on intravenous hydration, nasogastric tube decompression, and oral fluids incorporating an oral laxative, a digestant, and a defoaming agent. We compared differences between the groups in (1) the number of patients having a successful nonoperative treatment, (2) complications, and (3) recurrence of symptoms. RESULTS: A total of 116 and 120 patients comprised groups I and II, respectively. The number of patients treated successfully by a nonoperative approach was less in group I than in group II (77% vs 90%, P < .01). The complications and recurrence rate for groups I and II did not differ (4% vs 5% and 5% vs 4%, respectively). CONCLUSIONS: The NPO status for patients with adhesive, partial small-bowel obstruction may not be necessary. This cocktail of oral medications can decrease the need for operative intervention in patients with presumed adhesive, partial small-bowel obstruction.

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Administration, OralAdolescentAdultAgedAged, 80 and overAntifoaming AgentsCatharticsFemaleFluid TherapyGastrointestinal AgentsHumansIntestinal ObstructionIntestine, SmallIntubation, GastrointestinalMaleMiddle AgedRecurrenceTreatment OutcomeJournal ArticleRandomized Controlled Trial

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Shyr-Chyr Chen, Chien-Chang Lee, Zui-Shen Yen, Geng-Shiau Lin, Wen-Jone Chen, Po-Huang Lee, Hong-Shiee Lai, Fang-Yue Lin, Wei-Jao Chen. 2006. Specific oral medications decrease the need for surgery in adhesive partial small-bowel obstruction.. https://doi.org/10.1016/j.surg.2005.08.020

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