Effect of Simethicone on Postoperative Ileus in Patients Undergoing Colorectal Surgery
Effect of Simethicone on Postoperative Ileus in Patients Undergoing Colorectal Surgery
Post-operative ileus is a common complication following abdominal surgery. It results in
 abdominal distension, nausea and vomiting as well as abdominal pain. Furthermore, this
 results in prolonged hospital stay and occasionally readmission following abdominal
 surgery.The etiology of post-operative ileus is multifactorial and studies evaluating
 potential treatment options are abundant, though few reliable interventions exist. This study
 proposal describes a double-blinded randomized controlled trial investigating the effect of
 simethicone on post-operative ileus in patients undergoing colorectal surgery.
Simethicone is an orally administered anti-foaming agent comprised of polydimethylsiloxane
 and hydrated silica gel. Its leads to the coalescence of gas bubbles in the intestinal tract,
 facilitating its emission. To date, there are no contemporary studies evaluating the efficacy
 of simethicone on POI in patients undergoing colorectal surgery.

 The proposed study is a pilot double-blinded randomized controlled trial of simethicone
 versus placebo in patients undergoing colorectal surgery. Starting on postoperative day one,
 patients in the experimental arm of the study will receive, in a blinded fashion, 160mg of
 simethicone orally four times a day for the first five postoperative days. Patients assigned
 to the control arm will receive a placebo agent orally with the same frequency and duration.

 All consenting patients over the age of 18 undergoing elective, abdominal colorectal surgery
 involving bowel resection with or without re-anastomosis at either the Juravinski Hospital
 and Cancer Center or St. Joseph's Hospital in Hamilton, Ontario will be enrolled. This will
 include patients undergoing both open and laparoscopic surgery.

 Patients will be prospectively evaluated by a trained research assistant on a daily basis
 while in hospital. Passage of flatus, bowel movements, and postoperative pain will be
 evaluated at those visits. A two-week, and 30-day phone call to patients discharged from
 hospital will be done to assess for outcomes after discharge. Follow-up will end after the
 30th postoperative day.
Inclusion Criteria:

 -  All consenting patients over the age of 18 undergoing elective, abdominal colorectal
 surgery involving bowel resection with or without re-anastomosis (both open and
 laparoscopic surgeries) at either the Juravinski Hospital and Cancer Center or St.
 Joseph's Hospital in Hamilton

 Exclusion Criteria:

 -  Patients undergoing emergency surgery

 -  Documented allergy to simethicone

 -  Unable to provide informed consent (non-English speaking patients and those with
 cognitive impairment)

 -  Patients not having an abdominal operation (ie. perineal procedure)