Evaluation of the Effect of Oral Bisacodyl on Time of Return of Intestinal Motility after Cesarean Section

Background: Enhanced Recovery After Surgery (ERAS) is a widely adopted modern approach designed to optimize the efficiency and quality of patient care. Delayed return of bowel function is one of the most common complications following cesarean section (CS), contributing to patient discomfort, prolonged hospital stay, and increased healthcare costs. As CS remains among the most commonly performed surgical procedures worldwide, identifying safe and effective strategies to promote early gastrointestinal recovery has become a priority within ERAS protocols for obstetric care. Objective: The aim of this study is to evaluate the effect of oral bisacodyl on the time of return of intestinal sounds, first passage of flatus, and first defecation following elective cesarean section. Patients and methods: The study was a prospective, randomized clinical trial, conducted in the Maternity Hospital of Zagazig University Hospitals at the period from August 2022 to February 2023. The study included 88 pregnant females with gestational age range 38–42 weeks. Elective cesarean section was performed for all cases under spinal anesthesia. They were divided into two groups; Group A (study group): all patients included started one hour postoperatively, capsule 5 mg bisacodyl (repeated in 12 hours if no flatus). Group B (control group): patients received no bisacodyl or laxative Result: There was a significant difference between both study groups as regard early return bowel sound and time to first passage of flatus, which occurred earlier in the bisacodyl group (median 6 vs 8 hours and 12 vs 14 hours respectively, p<0.001). There were no significant differences between both study groups regarding other parameters as nausea, vomiting, abdominal distension, cramps (all p>0.05). Conclusion: Oral bisacodyl administration has a beneficial effect on gastrointestinal recovery after CS. Bisacodyl is safe, effective and well tolerated with no reported side effect. ？