Effect of pyridostigmine on the duration of post-operative ileus after colorectal surgery.

After bowel surgery, it is very common for the bowel to temporarily stop working — a complication called post-operative ileus. This can leave patients feeling bloated, nauseous, and unable to eat or drink, often extending their hospital stay significantly. Current recovery protocols have limited tools to speed up the return of normal bowel function. This trial tests whether adding a medication called pyridostigmine — which stimulates nerve signals to the gut — to the standard post-surgical recovery protocol can shorten the duration of post-operative ileus. You may be eligible if you are 18 or older, are scheduled for elective large or small bowel surgery (including reversal of a Hartmann's procedure or stoma formation) at the Central Adelaide Local Health Network, and are able to give consent. Exclusion criteria include a range of heart, neurological, or respiratory conditions, as well as pregnancy. This is a double-blind randomised controlled trial — neither you nor your doctors will know which treatment you are receiving until the study ends. The main outcome measured is how quickly normal bowel function returns after surgery. If effective, pyridostigmine could become a routine part of enhanced recovery protocols for bowel surgery patients.