Pyridostigmine to reduce the duration of postoperative Ileus in patients undergoing colorectal surgery

This Phase 2 trial tests whether a medication called pyridostigmine — originally used to treat a nerve-muscle condition called myasthenia gravis — can help restore bowel function faster after colorectal surgery. After operations on the bowel (such as removal of part of the colon), the gut often 'goes to sleep' for several days, causing nausea, bloating, and an inability to eat — a condition called postoperative ileus. This is one of the main reasons patients stay in hospital longer than expected. Pyridostigmine works by boosting the signals from nerves to the gut, potentially waking the bowel up sooner. Participants are randomly assigned to receive oral pyridostigmine or a placebo after their bowel surgery, and researchers track how quickly normal gut function returns. The trial is run within a modern enhanced recovery protocol, which already optimises many aspects of post-surgical care. You may be eligible if you are 18 or older, are undergoing planned colorectal surgery at the Royal Adelaide Hospital, and can give informed consent. People with certain heart conditions, asthma requiring regular medication, epilepsy, Parkinson's disease, peptic ulcers, significant kidney impairment, or active inflammatory bowel disease are not eligible.