Coffee hastens bowel recovery after colectomy

Individuals undergoing an elective open or laparoscopic colectomy recover bowel function more quickly if they drink coffee than if they drink water after the procedure, indicate the results of a German study.

The randomized clinical trial showed that patients assigned to drink coffee postoperatively also had a shorter time to tolerance of solid food and first flatus compared with their water-drinking counterparts.

The length of hospital stay was similar between groups, report the researchers in the British Journal of Surgery.

"A timely return of bowel mobility is highly relevant clinically as a delay causes discomfort to the patient, prolongs hospital stay and increases healthcare expenditure," remark Sascha Müller (University Hospital Heidelberg, Germany) and co-investigators.

"Postoperative coffee consumption is a cheap and safe way to activate bowel motility after elective colonic surgery," they add.

The team randomly assigned 80 colectomy patients recruited between March 2010 and March 2011 to drink either three 100 mL cups of coffee daily beginning the morning after surgery (n=40), or warm water (n=40), without additives, within 10 minutes, and under the supervision of a nurse.

Patients assigned to coffee drank a mean of 497 mL before their first bowel movement, the primary endpoint of the study, note the authors.

Of the 36 water-drinkers and 35 coffee-drinkers analyzed, the time to first bowel movement was significantly shorter in the latter group, at 60 versus 74 hours in the intention-to-treat analysis, and 62 versus 74 hours in the per-protocol analysis.

Drinking coffee and not water was also significantly associated with shorter time to first bowel movement in multivariate analysis, as was having an American Society of Anesthesiologists grade of II or III rather than I, report Müller and colleagues.

Furthermore, time to first flatus, tolerance of solid food, the need for laxatives, and length of hospital stay were all reduced in the coffee arm compared with the water arm. However, none of these associations were statistically significant.

The team observed no deaths within 30 days of surgery, and the overall morbidity rate was similar between groups.

Compared with the cost of alvimopan - a µ-receptor agonist previously proved to shorten time to gastrointestinal recovery - "drinking coffee is a considerably cheaper treatment with a similar effect," conclude the researchers.

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