Use of Non-Pharmacological Methods to Increase Intestinal Functions After Abdominal Surgery: What Do Say Evidences?

Year 2021, Issue: 14, 336 - 350, 31.08.2021

Burçin Irmak , Hülya Bulut

https://doi.org/10.38079/igusabder.957817

Cited By: 1

Abstract

Today, one of the most common problems faced by patients after abdominal surgery is gastrointestinal motility dysfunction. It occurs with signs and symptoms such as inability to pass gas, lack of bowel movement, abdominal pain, distention, nausea, vomiting, constipation in patients. Failure to control these symptoms early causes additional problems in patients such as fluid-electrolyte imbalance, delayed recovery, decreased comfort, prolonged hospital stay, and increased risk of hospital-acquired infection. Both pharmacological and non-pharmacological treatment methods are used to increase intestinal motility in the postoperative period. In the literature, it is stated that non-pharmacological methods such as early mobilization, chewing gum, early oral hydration (water, warm water, tea, coffee consumption) and hot application are effective in increasing intestinal motility. These methods are preferred for reasons such as being inexpensive, easy to apply, prevent drug side effects, and have no negative effects. In this review, studies with high evidence level regarding non-pharmacological methods used to increase bowel motility of patients after abdominal surgery are included. It is recommended that surgical nurses include evidence-based practices to increase gastrointestinal motility in nursing care and increase the number of randomized controlled clinical trials on the subject.

Keywords

Postoperative period, gastrointestinal motility, complementary medicine, nursing care

Abdominal Cerrahi Sonrasında Bağırsak Fonksiyonlarını Artırmada Farmakolojik Olmayan Yöntemlerin Kullanımı: Kanıtlar Ne Diyor?

Abstract

Günümüzde abdominal cerrahi sonrasında hastaların sıklıkla karşılaştığı sorunlardan biri gastrointestinal motilitede fonksiyon bozukluğudur. Hastalarda gaz çıkaramama, bağırsak hareketinin olmaması, karın ağrısı, distansiyon, bulantı, kusma, konstipasyon gibi belirti ve bulgularla ortaya çıkmaktadır. Bu semptomların erken sürede kontrol altına alınmaması hastalarda sıvı-elektrolit dengesizliği, iyileşmede gecikme, konforda azalma, hastanede yatış süresinde uzama, hastane kaynaklı enfeksiyon riskinin artması gibi ilave sorunlara neden olmaktadır. Ameliyat sonrası dönemde bağırsak motilitesini artırmada hem farmakolojik hem de farmakolojik olmayan tedavi yöntemleri kullanılmaktadır. Literatürde erken mobilizasyon, sakız çiğneme, erken oral hidrasyon (su, ılık su, çay, kahve tüketimi), sıcak uygulama gibi farmakolojik olmayan yöntemlerin bağırsak motilitesini arttırmada etkili olduğu yer almaktadır. Bu yöntemler ucuz olması, kolay uygulanabilmesi, ilaç yan etkilerini önlemesi, olumsuz etkilerinin olmaması gibi nedenlerle tercih edilmektedir. Bu derlemede, abdominal cerrahi sonrasında hastaların bağırsak motilitesini arttırmada kullanılan farmakolojik olmayan yöntemlere ilişkin kanıt düzeyi yüksek çalışmalara yer verilmiştir. Cerrahi hemşirelerinin gastrointestinal motiliteyi arttırmaya yönelik kanıta dayalı uygulamaları hemşirelik bakımına dahil etmeleri ve konuya ilişkin randomize kontrollü klinik çalışmaların artırılması önerilmektedir. 

Keywords

Ameliyat sonrası dönem, gastrointestinal motilite, tamamlayıcı tıp, hemşirelik bakımı

References

• Veličković J, Feng C, Palibrk I, Veličković D, Jovanović B, Bumbaširević V. The assessment of complications after major abdominal surgery: a comparison of two scales. J Surg Res. 2020;247:397-405. doi:10.1016/j.jss.2019.10.003.
• İzveren AÖ, Dal Ü. Abdominal cerrahi girişim uygulanan hastalarda görülen erken dönem sorunları ve bu sorunlara yönelik hemşirelik uygulamaları. Hacettepe University Faculty of Health Sciences Nursing Journal. 2011;18(2):36-46.
• Taşdemir N, Çelik SŞ. Hastaların cerrahi girişim sonrası abdominal distansiyona yönelik deneyimleri. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2010; 26(3):23-31.
• Lassen K, Soop M, Nygren J, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Archives of Surgery. 2009;144(10):961-969. doi:10.1001/archsurg.2009.170.
• Bozkırlı BO, Gündoğdu RH, Ersoy PE, Akbaba S, Temel H, Sayın T. ERAS protokolü kolorektal cerrahi sonuçlarımızı etkiledi mi? Ulusal Cerrahi Dergisi. 2012;28(3):149-152. doi:10.5152/UCD.2012.05.
• Gungorduk K, Ozdemir IA. Non-pharmacological interventions for the prevention of postoperative ileus after gynecologic cancer surgery. Taiwanese Journal of Obstetrics and Gynecology. 2021;60(1):9-12. doi:10.1016/j.tjog.2020.11.002.
• Bulechek G, Butcher H, Dochterman J, Wagner C. Hemşirelik Girişimleri Sınıflaması (NIC). Erdemir F, Kav S, Yılmaz AA, eds. 6. baskı. İstanbul: Nobel Tıp Kitabevi; 2017.
• Uysal H. Gastrointestinal sistemin tanılaması ve fiziksel muayene. In: Enç N, ed. Sağlık Tanılaması ve Fiziksel Muayene. 1. baskı. İstanbul: Nobel Tıp Kitabevleri; 2015:71-90.
• Gustafsson U, Scott M, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World Journal of Surgery. 2019;43(3):659-695. doi:10.1007/s00268-018-4844-y.
• Mathiasen MC, Andersen RM, Schmidt DS, Thomsen T, Vinther A, Danielsen AK. Early mobilisation after colorectal surgery: a qualitative study. Gastrointestinal Nursing. 2021;19(3):30-36. doi:10.12968/gasn.2021.19.3.30.
• Liebermann M, Awad M, Dejong M, Rivard C, Sinacore J, Brubaker L. Ambulation of hospitalized gynecologic surgical patients: a randomized controlled trial. Obstet Gynecol. 2013;121(3):533-537. doi:10.1097/AOG.0b013e318280d50a.
• Nishijima M, Baba H, Murotani K, et al. Early ambulation after general and digestive surgery: a retrospective single-center study. Langenbeck's Archives of Surgery. 2020;405(5):613-622. doi:10.1007/s00423-020-01925-9.
• Pashikanti L, Von Ah D. Impact of early mobilization protocol on the medical-surgical inpatient population: an integrated review of literature. Clinical Nurse Specialist. 2012;26(2):87-94.doi:10.1097/NUR.0b013e31824590e6.
• Vather R, Bissett I. Management of prolonged post‐operative ileus: evidence‐based recommendations. ANZ Journal of Surgery. 2013;83(5):319-324. doi:10.1111/ans.12102.
• Svensson-Raskh A, Schandl AR, Ståhle A, Nygren-Bonnier M, Fagevik Olsén M. Mobilization started within 2 hours after abdominal surgery improves peripheral and arterial oxygenation: a single-center randomized controlled trial. Physical Therapy. 2021;101(5):1-11. doi:10.1093/ptj/pzab094.
• Herman A, Santoso B, Yunitasari E. The effect of early mobilization on intestinal peristaltics in patients after a cesarean section in Kendari City Hospital. Jurnal Ners. 2019;14(3):288-291. doi:10.20473/jn.v14i3.17148.
• Terzioglu F, Şimsek S, Karaca K, Sariince N, Altunsoy P, Salman MC. Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery. J Clin Nurs. 2013;22(13-14):1917-1925. doi:10.1111/jocn.12172.
• Wu M, Yang L, Zeng X, et al. Safety and feasibility of early oral hydration in the postanesthesia care unit after laparoscopic cholecystectomy: a prospective, randomized, and controlled study. Journal of PeriAnesthesia Nursing. 2019;34(2):425-430. doi:10.1016/j.jopan.2018.06.093.
• Çaliskan N, Bulut H, Konan A. The effect of warm water intake on bowel movements in the early postoperative stage of patients having undergone laparoscopic cholecystectomy: a randomized controlled trial. Gastroenterology Nursing. 2016;39(5):340-347. doi:10.1097/SGA.0000000000000181.
• Yin X, Yang L, Xiang S, Wu Y, Li Q. Effectiveness of early postoperative oral hydration after colorectal surgery with general anesthesia: a prospective randomized controlled trial. Research Square. https://www.researchsquare.com/article/rs-8066/v1. Yayınlanma Tarihi 25 Kasım 2019. Erişim tarihi 5 Haziran 2021. doi: 10.21203/rs.2.17432/v1
• Phutsisen J, Kietpeerakool C, Jampathong N, et al. Effects of Cassia alata Linn on bowel function recovery following surgery for gynecological cancer: a randomized controlled trial. Complement Ther Med. 2019;47:1-5. doi:10.1016/j.ctim.2019.102222.
• Brown S, Cann P, Read N. Effect of coffee on distal colon function. Gut. 1990;31(4):450-453. doi:10.1136/gut.31.4.450.
• Rao SS, Welcher K, Zimmerman B, Stumbo P. Is coffee a colonie stimulant? Eur J Gastroenterol Hepatol. 1998;10(2):113-118. doi:10.1097/00042737-199802000-00003.
• Hayashi K, Tsunoda A, Shiraishi A, Kusanagi H. Quantification of the effects of coffee on postoperative ileus after laparoscopic ventral rectopexy: a randomized controlled trial. European Surgery. 2019;51(6):325-332.doi:10.1007/s10353-019-0605-x.
• Hasler-Gehrer S, Linecker M, Keerl A, et al. Does coffee intake reduce postoperative ileus after laparoscopic elective colorectal surgery? A prospective, randomized controlled study: the coffee study. Diseases of the Colon & Rectum. 2019;62(8):997-1004. doi:10.1097/DCR.0000000000001405.
• Piric M, Pasic F, Rifatbegovic Z, Konjic F. The effects of drinking coffee while recovering from colon and rectal resection surgery. Med Arh. 2015;69(6):357-361. doi:10.5455/medarh.2015.69.357-361.
• Dulskas A, Klimovskij M, Vitkauskiene M, Samalavicius NE. Effect of coffee on the length of postoperative ileus after elective laparoscopic left-sided colectomy: a randomized, prospective single-center study. Diseases of the Colon & Rectum. 2015;58(11):1064-1069. doi:10.1097/DCR.0000000000000449.
• Müller SA, Rahbari N, Schneider F, et al. Randomized clinical trial on the effect of coffee on postoperative ileus following elective colectomy. British Journal of Surgery. 2012;99(11):1530-1538. doi:10.1002/bjs.8885.
• Güngördük K, Özdemir İA, Güngördük Ö, Gülseren V, Gokçü M, Sancı M. Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2017;216(2):145.e1-7. doi:10.1016/j.ajog.2016.10.019.
• Gungorduk K, Paskal EK, Demirayak G, Koseoğlu SB, Akbaba E, Ozdemir IA. Coffee consumption for recovery of intestinal function after laparoscopic gynecological surgery: a randomized controlled trial. International Journal of Surgery. 2020;82:130-135. doi:10.1016/j.ijsu.2020.08.016.
• Goymen A, Simsek Y, Ozkaplan SE, et al. Effect of gum chewing and coffee consumption on intestinal motility in caesarean sections. J Clin Anal Med. 2017;8(5):411-415. doi:10.4328/JCAM.4901.
• Rabiepoor S, Yas A, Navaei J, Khalkhali HR. Does coffee affect the bowel function after caesarean section? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2018(1);220:96-99. doi:10.1016/j.ejogrb.2017.07.028.
• Kanza Gül D, Şolt Kırca A. Effects of acupressure, gum chewing and coffee consumption on the gastrointestinal system after caesarean section under spinal anaesthesia. Journal of Obstetrics and Gynaecology. 2021;41(4):573-580. doi:10.1080/01443615.2020.1787363.
• Koseoglu SB, Toker MK, Gokbel I, Celikkol O, Gungorduk K. Can coffee consumption be used to accelerate the recovery of bowel function after cesarean section? Randomized prospective trial. Ginekologia Polska. 2020;91(2):85-90. doi:10.5603/GP.2020.0014.
• Kane TD, Tubog TD, Schmidt JR. The use of coffee to decrease the incidence of postoperative ileus: a systematic review and meta-analysis. Journal of PeriAnesthesia Nursing. 2020;35(2):171-177. doi:10.1016/j.jopan.2019.07.004.
• Gkegkes ID, Minis EE, Iavazzo C. Effect of caffeine intake on postoperative ileus: a systematic review and meta-analysis. Dig Surg. 2020;37(1):22-31. doi:10.1159/000496431.
• Cornwall HL, Edwards BA, Curran JF, Boyce S. Coffee to go? The effect of coffee on resolution of ileus following abdominal surgery: a systematic review and meta-analysis of randomised controlled trials. Clinical Nutrition. 2020;39(5):1385-1394. doi:10.1016/j.clnu.2019.06.003.
• Eamudomkarn N, Kietpeerakool C, Kaewrudee S, Jampathong N, Ngamjarus C, Lumbiganon P. Effect of postoperative coffee consumption on gastrointestinal function after abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. Scientific Reports. 2018;8(1):1-9. doi:10.1038/s41598-018-35752-2.
• Li S, Liu Y, Peng Q, Xie L, Wang J, Qin X. Chewing gum reduces postoperative ileus following abdominal surgery: a meta‐analysis of 17 randomized controlled trials. J Gastroenterol Hepatol. 2013;28(7):1122-1132. doi:10.1111/jgh.12206.
• Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database of Systematic Reviews. 2015;20(2):CD006506. doi:10.1002/14651858.CD006506.pub3.
• de Leede EM, van Leersum NJ, Kroon HM, van Weel V, van der Sijp JRM, Bonsing BA. Multicentre randomized clinical trial of the effect of chewing gum after abdominal surgery. British journal of surgery. 2018;105(7):820‐828. doi:10.1002/bjs.10828.
• Makino Y, Choe M-A. Effects of hot packs on small-intestinal motility measured by doppler ultrasound and subjective feelings in normal adults. Gastroenterology Nursing. 2017;40(4):279-286. doi:10.1097/SGA.0000000000000222.
• Aydın H. Jinekolojik cerrahi sonrası sakız çiğneme ve sıcak uygulamanın hastaların bağırsak fonksiyonlarına etkisinin karşılaştırılması [Yüksek Lisans Tezi]. Bursa, Türkiye: Hemşirelik Anabilim Dalı, Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü;2019.
• Cao L, Wang T, Lin J, et al. Effect of Yikou-Sizi powder hot compress on gastrointestinal functional recovery in patients after abdominal surgery: study protocol for a randomized controlled trial. Medicine. 2018;97(38):1-6. doi:10.1097/MD.0000000000012438.
• Cao LX, Chen ZQ, Jiang Z, et al. Rapid rehabilitation technique with integrated traditional Chinese and Western medicine promotes postoperative gastrointestinal function recovery. World J Gastroenterol. 2020;26(23):3271-3282. doi:10.3748/wjg.v26.i23.3271.
• Turan EA. Sıcak su ayak banyosunun sezaryen sonrası gaz çıkışı ve ağrıya etkisi [Doktora Tezi]. Malatya, Türkiye: Hemşirelik Anabilim Dalı, İnönü Üniversitesi Sağlık Bilimleri Enstitüsü;2020.
• Tanab L, Huangb G, Lib X, Yina X, Wanga M, Lia J. Clinical application of combined Traditional Chinese Medicine (TCM) for warm compression of umbilical region in promoting postoperative recovery of bowel function in patients with bile duct stones. Int J Case Rep Clin Image. 2020;2(3):1-4. doi:10.36266/IJCRCI/137.