Effect of Pre-operative Carbohydrate Loading on Return of Bowel Function After Reversal of Ileostomy

An ileostomy is a common surgery in which part of the small intestine is brought to the surface of the abdomen to allow waste to leave the body. When it is no longer needed, another operation is performed to reconnect the intestine (ileostomy reversal). Although ileostomy reversal is usually a straightforward procedure, some patients experience a temporary slowing or stopping of bowel function after surgery, called post-operative ileus. This can affect up to 3 out of every 10 patients. Symptoms may include nausea, vomiting, bloating, difficulty eating, and not passing gas or stool. Post-operative ileus occurs because surgery, anesthesia, inflammation, and fluid shifts can temporarily affect how the intestines work. When bowel function takes longer than expected to return, patients may need to stay in the hospital longer and may experience additional stress and discomfort. Enhanced Recovery After Surgery (ERAS) programs are designed to help patients recover more quickly after surgery. One important part of these programs is pre-operative carbohydrate loading, where patients drink a carbohydrate-rich beverage before surgery. Research suggests that this may improve the body's response to surgery, reduce nausea and vomiting, and help bowel function return sooner. At Indus Hospital Karachi, ileostomy reversals are commonly performed, particularly in young and middle-aged patients. Finding ways to reduce post-operative ileus could shorten hospital stays, help patients return to their normal activities sooner, and reduce pressure on healthcare resources.

Inclusion Criteria: * Age above 18 years * ASA class 2 and below Exclusion Criteria: * · Evidence of chronic/active intestinal disease * Post-operative complication/morbidity besides postoperative ileus * Failure of conservative management at more than 72 hours