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Gastrointestinal motor activity associated with postoperative ileus and emesis

The gastrointestinal motor activity associated with post‐operative ileus and emesis has not been fully elucidated. This study has evaluated gastric and small‐bowel motility in six patients before and after cholecystectomy and in six healthy volunteers, by solid‐state manometry. Nausea and vomiting were recorded post‐operatively. After surgery, fasting motor abnormalities including (a) total gastric quiescence and (b) small‐bowel ‘phasic‐bursts’ of contractions were observed in all patients. Phasic bursts (PB) resembled phase III of the migrating motor complex (MMC) on initial visual inspection, but further analysis revealed that they were of shorter duration (3.4 ±.2 min [PB] vs 6.4 ± 0.8 min [MMC], [mean ± SEM] P < 0.01), lower contraction frequency (6.4 ± 0.1 contractions min −1 [PBj vs 10 ± 0.3 contractions min−1 [MMC] [mean ± SEM] P < 0.01) and shorter periodicity (36.4 ± 3 min [PB] vs 70.0 ± 6 min [MMC] [mean ± SEM] P < 0.01). Four patients experienced nausea during phasic burst activity. Vomiting was only observed in association with retrograde phasic‐bursts, which migrated through the duodenum to the stomach. This study has shown consistent gastrointestinal motor abnormalities in the immediate post‐operative state.