Does Coffee Affect Bowel Recovery after Minimally Invasive Colectomy? A 3-Armed Randomized Controlled Trial

Introduction: Previous studies have suggested that coffee may hasten postoperative bowel recovery. We sought to evaluate the impact of both coffee and caffeine on shortening the return of postoperative bowel function after minimally invasive colectomy. Methods: This was a single-center, prospective, randomized controlled clinical trial conducted in a tertiary hospital. Patients undergoing an elective robotic or laparoscopic colectomy without an ostomy were randomized into 3 groups: warm water (WW), decaffeinated coffee (DC), and caffeinated coffee (CC). Subjects were assigned to drink a 4-ounce cup 3 times daily starting on postoperative day 1. The primary outcome was time to first bowel movement and was assessed by multivariable linear regression models. Secondary outcomes included time to first flatus, length of hospital stay, and postoperative morbidity. Results: A total of 99 patients were included in this study: 31 WW, 31 DC, and 37 CC. The groups were similar in age and sex (p = 0.51 & 0.91, respectively). Mean (SD) time to the first bowel movement in days was 2.94 (1.4), 2.58 (1.2), and 2.86 (1.3), respectively (p = 0.53). There were no significant differences observed in length of hospital stay (p = 0.056) and postoperative morbidity (p = 0.52). Multivariable linear regression analysis did not reveal a statistically significant association between any of three intervention and either time to first bowel movement or time to first flatus. Conclusion: Coffee (caffeinated or decaffeinated) does not expedite the return of bowel function after minimally invasive colectomy. Larger, standardized trials will provide further insight into the clinical effectiveness of coffee on bowel recovery.