A PROSPECTIVE STUDY OF FACTORS INFLUENCING RETURN OF BOWEL ACTIVITY AFTER EXPLORATORY LAPAROTOMY

*Dr. Jitendra Singh Chouhan, Dr. D. K. Sharma, Dr. Sony Saju and Dr. Alpesh Kothari

ABSTRACT

Background: The intestines, comprising the small and large intestines, play a crucial role in nutrient absorption and overall body function. Pathological conditions affecting the bowels can disrupt the body's delicate balance. During abdominal surgery, normal abdominal functions are temporarily halted, and restoring them quickly is a primary goal. Postoperative ileus (POI), characterized by gastrointestinal motility inhibition, significantly impacts patients' recovery, causing discomfort, pain, and delayed hospital discharge. This prospective study aims to investigate the prevalence of POI and assess risk factors associated with its occurrence and progression. Understanding POI is vital for improving patient outcomes and promoting faster recovery after abdominal surgeries. Methods: This hospital-based prospective study included patients who underwent surgery at Rabindranath Tagore Medical College, Udaipur. Data was collected using a standardized proforma, including relevant clinical history, pre-operative and post-operative investigations. Statistical analysis involved descriptive statistics, t-tests, nonparametric tests, chi-square tests, and multivariate logistic regression analysis. Results: In this study males (59.03%) were predominant in numbers than females (40.96%). Bowel motility appeared earlier in females (91.17%) compared to males (89.79%). Factors significantly associated with POI in the univariate analysis were stoma (p≤0.001), blood transfusion p=0.048), peritoneal contamination (p≤0.001), higher preoperative haemoglobin (p=0.009), Duration of surgery (p=0.005), postoperative chloride (p<0.001). Conclusion: In the present study appearance of bowel motility was found to be significantly earlier in patients with shorter duration of surgery, less intraperitoneal contamination, presence of stoma, not receiving intra- or post-operative blood transfusion, shorter duration of surgery, higher preoperative haemoglobin and higher postoperative chloride. This study recommends use of passage of flatus over auscultation of bowel sounds for purpose of starting oral intake in patients undergoing laparotomy as the latter can be positive even in regional return of bowel activity.

Keywords: Intestines, Postoperative Ileus, Risk Factors, Bowel Function.