Cyclooxygenase Inhibitors and Postoperative Bowel Function

In animal studies, prostaglandin inhibition reduced postoperative ileus by reducing inflammatory cells in the bowel wall. To determine whether prostaglandin inhibitors would confer similar benefits in humans, investigators in Australia randomized 210 patients undergoing major gastrointestinal surgery to receive celecoxib (Celebrex; 100 mg), diclofenac (50 mg), or placebo. Patients received twice-daily doses 1 day before surgery and then for 7 days after surgery or until discharge, if earlier. Patient demographics and types of surgery were similar in all groups.

Of primary endpoints, time to flatus, oral intake, and need for intravenous fluids were similar in all groups, although time to first bowel movement was 1 day shorter in the diclofena…