Coffee After Colon Surgery Reduces Time to Bowel Movement

Larry Hand

October 10, 2012

October 10, 2012 — Drinking caffeinated coffee, as opposed to just water, after bowel surgery improved the time to first postoperative bowel movement by 14 hours, according to a study published online September 14 and in the November print issue of the British Journal of Surgery.

Sascha A. Müller, MD, from the Department of Surgery, Kantonsspital St. Gallen, Switzerland, and colleagues conducted an open-label trial involving 80 patients (mean age, 61 years) who underwent colectomy surgery in 3 German hospitals, all headed by senior author Markus W. Büchler, DM, a surgeon with the University of Heidelberg in Germany. Most patients (56%) were having surgery because of colon cancer, and most (87%) were coffee drinkers before surgery.

The researchers recruited patients between March 2010 and March 2011 and randomly assigned them to receive either 100 mL coffee or warm water 3 times per day after open or laparoscopic surgery. After exclusion for various reasons, the final analysis involved 35 patients in the coffee group and 36 patients in the control group.

The coffee drinkers experienced a shorter time to first bowel movement compared with the water drinkers (60.4 vs 74.0 hours; P = .006). In an intention-to-treat analysis, the absolute difference in first bowel movement was 13.6 hours (95% confidence interval [CI], 4.0 - 23.2 hours), and in a per protocol analysis, the absolute difference was 11.6 hours (95% CI, 1.3 - 21.9 hours). In secondary per protocol analyses, the time before tolerance of solid food was 45.1 hours for coffee drinkers compared with 57.3 hours for water drinkers (P = .038), and the time before the first flatus was 40.6 hours for coffee drinkers and 47.1 hours for water drinkers (P = .191).

The mechanism by which coffee would cause this effect is unknown, the researchers write. However, the mechanism probably involves something other than caffeine, because a previous study concluded that decaffeinated coffee had an effect on bowel contractions. Only caffeinated coffee was used in this study.

Postoperative ileus is common after abdominal surgery, the authors write. The complication adds an estimated $750 million per year of extra hospital costs in the United States, according to previous research. "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," the researchers note.

Limitations of the study include the possibility that assumptions for the sample size were arbitrary because no previous studies have examined this topic. However, the researchers write, "Considering that coffee consumption is part of the lifestyle of many patients and its side-effects are well known, the effect of 14 [hours] might still be of clinical interest."

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

The authors have disclosed no relevant financial relationships.

Brit J Surg. 2012:99:1530-1538. Full text