Background

Postoperative ileus is the medical term for a functional obstruction of the bowel, and a common complication in persons who undergo abdominal surgery. It is characterized by lack of bowel movements, causing an accumulation of bowel contents, and delayed flatus (passing gas). Persons with persistent postoperative ileus are immobilized, have discomfort and pain, and are at increased risk for other complications. This results in prolonged hospitalisation and increased medical costs. Daikenchuto is a Japanese traditional medicine (also known as Kampo) that may reduce postoperative ileus.

Review question

This review investigated whether Daikenchuto reduced postoperative ileus in persons undergoing abdominal surgery.

Study characteristics

We included seven studies (1202 participants), in which the participants were allocated at random (by chance alone) to receive one of several clinical interventions, where Daikenchuto was compared with any other medicine, placebo, or no treatment. The searches were performed 3 July 2017. We evaluated: time from completion of abdominal surgery to first flatus, time to first bowel movement, time to resumption of regular solid food intake, adverse events related to Daikenchuto, patient satisfaction, re-interventions for postoperative ileus before leaving hospital, and length of hospital stay.

Key results and quality of evidence

Overall, there were a small number of participants included in each analysis. We could not fully investigate time from surgery to first flatus, to first bowel movement, or to resumption of regular solid food intake, any medicine-related adverse events, patient satisfaction, any re-interventions for postoperative ileus before leaving hospital, or length of hospital stay.
We considered the quality of evidence for all presented outcomes as moderate to very low.

Authors’ conclusion

Based upon our findings, it was uncertain whether Daikenchuto accelerated post-surgical bowel motility in persons undergoing abdominal surgery, and thus, unclear whether Daikenchuto reduced postoperative ileus.