EFFECT OF PRE-OPERATIVE CARBOHYDRATE LOADING ON RETURN OF BOWEL FUNCTION AFTER REVERSAL OF ILEOSTOMY: A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: To compare time to return of bowel function in patients receiving preoperative carbohydrate loading versus placebo following ileostomy reversal. Methodology: This randomized controlled trial parallel trial was conducted at The Indus Hospital, Karachi from 15th October 2025 to 14th April 2026 after IRB approval. Sixty-six patients undergoing elective ileostomy reversal were randomly assigned to receive a carbohydrate-rich drink (Group A, n=33) or placebo (Group B, n=33). Primary outcome was time to first flatus. Secondary outcomes included audible bowel sounds, semi-solid tolerance, nausea/vomiting, and postoperative ileus. Result: Mean age was 42.16±9.37 years; 41 (62.1%) were males. Carbohydrate group showed significantly earlier flatus time 23.6±12.0 vs. 41.7±14.4 hours; mean difference-18.55 hours, 95% CI _24.59 to _12.49; p<0.001. Audible bowel sounds at 48 hours were present in 93.8% vs. 52.9% (p<0.001). No significant differences were observed for semi-solid tolerance, nausea/vomiting, or postoperative ileus. Conclusion: Preoperative carbohydrate loading significantly accelerates bowel function recovery after ileostomy reversal. Routine implementation is recommended given its simplicity, safety, and low cost.