Drinking coffee after elective colectomy might improve postoperative ileus and shorten the time to first bowel movement, according to a study published in the British Journal of Surgery.

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Postoperative ileus is common after abdominal surgery, often leading to an increased length of hospital stay and an associated increase in health-care costs. “Many people say that there is a correlation between coffee consumption and bowel movement,” says lead author Sascha Müller, a self-confessed coffee fan. “After reading a randomized controlled trial focussing on postoperative bowel movement after chewing gum, I wondered if there is a similar effect after coffee intake.” Although much is known about the effects of coffee on the body, previous studies of the effects on intestinal motility have only included healthy volunteers.

A multicentre, parallel, open-label, randomized trial was performed. 80 patients with malignant or benign diseases undergoing elective open or laparoscopic colectomy were randomly assigned to receive either 100 ml coffee or water three times daily after their surgery.

The time to first bowel movement was significantly shorter in the coffee arm than the water arm (60.4 h versus 74 h respectively). Time to tolerance of solid food showed a similar trend, although the difference was not statistically significant. Length of hospital stay and morbidity were comparable in both groups. No coffee-related complications were noted (although some patients did not want to drink coffee). One of the limitations of the study was the fairly high rate of protocol violation in the group of patients receiving water—patients in this group were instructed not to drink coffee, but all patients had free access to it.

Various drugs for the treatment of postoperative ileus are currently in clinical trials, but the researchers believe that this is the first clinical trial addressing the effect of postoperative coffee intake. They note that this study does not reveal the mechanisms by which coffee has its effect on intestinal motility. Müller now wants to address the question of whether caffeine is responsible for this effect, and to this end a randomized, fully blinded trial is in preparation.

The researchers conclude that coffee consumption is a cheap and safe way to activate bowel motility after colectomy.