{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T15:42:54Z","timestamp":1786203774824,"version":"build-2736575974"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Siriraj Research Development Fund, Faculty of Medicine Siriraj Hospital, Mahidol University","award":["R016632024"],"award-info":[{"award-number":["R016632024"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether adding milk of magnesia (MOM) to an enhanced recovery after surgery (ERAS) pathway prevents postoperative ileus (POI) and improves postoperative bowel function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This randomized controlled trial at the Gynecology Unit, Siriraj Hospital (Bangkok, Thailand) enrolled patients undergoing hysterectomy for benign or malignant indications during September 2023 through February 2024. Participants were randomly assigned to ERAS alone (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980) or ERAS plus MOM (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980). The MOM group received 15\u00a0mL on postoperative day 0 and then 30\u00a0mL twice daily until first flatus or bowel movement. The primary outcome was the time from surgery to resumption of a well-tolerated solid diet. Secondary outcomes included POI incidence, time to first flatus, patient-reported outcomes, and MOM-related complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 160 patients, 60 (37.5%) had gynecologic malignancies: endometrial cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934), ovarian cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), cervical cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), and leiomyosarcoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). Time to well-tolerated solid diet was significantly shorter in the MOM group compared with the control group (20.6\u2009\u00b1\u200910.9 vs 28.8\u2009\u00b1\u200916.3\u00a0h;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The incidence of POI was also significantly lower (3.8% vs 27.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and time to first flatus was shorter (17.1\u2009\u00b1\u20097.9 vs 22.3\u2009\u00b1\u200910.8\u00a0h;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patient-reported outcomes favored the MOM group, with higher eating and daily activity satisfaction scores. No severe adverse events occurred in the MOM group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adding MOM to ERAS was associated with reduced POI incidence and faster recovery of bowel function in patients undergoing abdominal hysterectomy for benign or malignant conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Thai Clinical Trials Registry (TCTR: TCTR20230816005), registered on 16 August 2023.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-11023-z","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T05:15:03Z","timestamp":1784351703000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Milk of magnesia in enhanced recovery after surgery for preventing postoperative ileus after hysterectomy: randomized controlled trial"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8427-8266","authenticated-orcid":false,"given":"Wathirada","family":"Karnchanabanyong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9888-7479","authenticated-orcid":false,"given":"Irene","family":"Ruengkhachorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1913-6613","authenticated-orcid":false,"given":"Nida","family":"Jareemit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3902-7323","authenticated-orcid":false,"given":"Jiraporn","family":"Thurakit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3195-5737","authenticated-orcid":false,"given":"Darisa","family":"Sriclung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2236-4353","authenticated-orcid":false,"given":"Raveewan","family":"Sangprasert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2562-5731","authenticated-orcid":false,"given":"Natchanon","family":"Sathapanapitagkit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3234-2724","authenticated-orcid":false,"given":"Jarin","family":"Ketthong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2334-4899","authenticated-orcid":false,"given":"Sompop","family":"Kuljarusnont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"issue":"6","key":"11023_CR1","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.jviscsurg.2016.08.010","volume":"153","author":"A Venara","year":"2016","unstructured":"Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A et al (2016) Postoperative ileus: pathophysiology, incidence, and prevention. J Visc Surg 153(6):439\u2013446","journal-title":"J Visc Surg"},{"issue":"8","key":"11023_CR2","first-page":"469","volume":"111","author":"J Fanning","year":"2011","unstructured":"Fanning J, Hojat R (2011) Safety and efficacy of immediate postoperative feeding and bowel stimulation to prevent ileus after major gynecologic surgical procedures. J Am Osteopath Assoc 111(8):469\u2013472","journal-title":"J Am Osteopath Assoc"},{"issue":"2","key":"11023_CR3","doi-asserted-by":"publisher","first-page":"145.e1","DOI":"10.1016\/j.ajog.2016.10.019","volume":"216","author":"K G\u00fcng\u00f6rd\u00fck","year":"2017","unstructured":"G\u00fcng\u00f6rd\u00fck K, \u00d6zdemir \u0130A, G\u00fcng\u00f6rd\u00fck \u00d6, G\u00fclseren V, Gok\u00e7\u00fc M, Sanc\u0131 M (2017) Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial. Am J Obstet Gynecol 216(2):145.e1-145.e7","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"11023_CR4","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1007\/s00384-020-03698-5","volume":"35","author":"Z-L Li","year":"2020","unstructured":"Li Z-L, Zhao B-C, Deng W-T, Zhuang P-P, Liu W-F, Li C et al (2020) Incidence and risk factors of postoperative ileus after hysterectomy for benign indications. Int J Colorectal Dis 35(11):2105\u20132112","journal-title":"Int J Colorectal Dis"},{"issue":"1","key":"11023_CR5","doi-asserted-by":"publisher","first-page":"17349","DOI":"10.1038\/s41598-018-35752-2","volume":"8","author":"N Eamudomkarn","year":"2018","unstructured":"Eamudomkarn N, Kietpeerakool C, Kaewrudee S, Jampathong N, Ngamjarus C (2018) Lumbiganon P (2018) Effect of postoperative coffee consumption on gastrointestinal function after abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 8(1):17349","journal-title":"Sci Rep"},{"issue":"4","key":"11023_CR6","first-page":"265","volume":"31","author":"Y Jirawongprapa","year":"2023","unstructured":"Jirawongprapa Y, Chotboon C, Songthamwat S, Summart U, Songthamwat M (2023) Effects of caffeine dose on bowel function recovery following gynecologic cancer surgery: a randomized double-blind controlled trial. Thai J Obstet Gynaecol 31(4):265\u2013272","journal-title":"Thai J Obstet Gynaecol"},{"issue":"5","key":"11023_CR7","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1080\/01443615.2021.1941821","volume":"42","author":"P Kadirogullari","year":"2022","unstructured":"Kadirogullari P, Seckin KD, Yalcin Bahat P, Aytufan Z (2022) The effect of chewing gum on bowel function postoperatively in patients with total laparoscopic hysterectomy: a randomised controlled trial. J Obstet Gynaecol 42(5):1192\u20131197","journal-title":"J Obstet Gynaecol"},{"issue":"3","key":"11023_CR8","first-page":"192","volume":"31","author":"C Sillapasa","year":"2023","unstructured":"Sillapasa C, Jeerasap R, Tangsiriwatthana T (2023) Metoclopramide for Preventing Ileus after Benign Gynecologic Surgery: A randomized controlled trial. Thai Journal of Obstetrics and Gynaecology 31(3):192\u2013200","journal-title":"Thai Journal of Obstetrics and Gynaecology"},{"issue":"1","key":"11023_CR9","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ajog.2005.06.046","volume":"194","author":"N Chaiyakunapruk","year":"2006","unstructured":"Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, Leeprakobboon K, Leelasettagool C (2006) The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol 194(1):95\u201399","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"11023_CR10","first-page":"53","volume":"33","author":"P Pongsupanimit","year":"2025","unstructured":"Pongsupanimit P, Chaikomin R, Tripatara P, Achariyapota V, Viriyapak B, Kanpetpanao S et al (2025) The impact of ginger on preventing postoperative ileus after hysterectomy under the enhanced recovery after surgery protocol: a randomized controlled trial. Thai J Obstet Gynaecol 33(1):53\u201363","journal-title":"Thai J Obstet Gynaecol"},{"issue":"4","key":"11023_CR11","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1136\/ijgc-2019-000356","volume":"29","author":"G Nelson","year":"2019","unstructured":"Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA et al (2019) Guidelines for perioperative care in gynecologic\/oncology: enhanced recovery after surgery (ERAS) society recommendations-2019 update. Int J Gynecol Cancer 29(4):651\u2013668","journal-title":"Int J Gynecol Cancer"},{"issue":"1","key":"11023_CR12","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1002\/ijgo.14386","volume":"160","author":"NR G\u00f3mez-Hidalgo","year":"2023","unstructured":"G\u00f3mez-Hidalgo NR, Pletnev A, Razumova Z, Bizzarri N, Selcuk I, Theofanakis C et al (2023) European enhanced recovery after surgery (ERAS) gynecologic oncology survey: status of ERAS protocol implementation across Europe. Int J Gynaecol Obstet 160(1):306\u2013312","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"11023_CR13","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1006\/gyno.1999.5401","volume":"73","author":"J Fanning","year":"1999","unstructured":"Fanning J, Yu-Brekke S (1999) Prospective trial of aggressive postoperative bowel stimulation following radical hysterectomy. Gynecol Oncol 73(3):412\u2013414","journal-title":"Gynecol Oncol"},{"issue":"3","key":"11023_CR14","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1006\/gyno.1997.4860","volume":"67","author":"JM Schilder","year":"1997","unstructured":"Schilder JM, Hurteau JA, Look KY, Moore DH, Raff G, Stehman FB et al (1997) A prospective controlled trial of early postoperative oral intake following major abdominal gynecologic surgery. Gynecol Oncol 67(3):235\u2013240","journal-title":"Gynecol Oncol"},{"issue":"5","key":"11023_CR15","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1007\/s11605-013-2148-y","volume":"17","author":"R Vather","year":"2013","unstructured":"Vather R, Trivedi S, Bissett I (2013) Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg 17(5):962\u2013972","journal-title":"J Gastrointest Surg"},{"key":"11023_CR16","volume-title":"Goodman & Gilman\u2019s the pharmacological basis of therapeutics","year":"2018","unstructured":"Brunton LL, Hilal-Dandan R, Knollmann BC (eds) (2018) Goodman & Gilman\u2019s the pharmacological basis of therapeutics, 13th ed. McGraw-Hill Education, New York","edition":"13th ed"},{"key":"11023_CR17","doi-asserted-by":"crossref","unstructured":"Tatar C, Hinckley S, Holubar SD, L\u00ed\u0161ka D, Delaney CP, Steele SR et al (2022) Does milk of magnesia impact length of hospital stay after major colorectal resection. ANZ J Surg 93","DOI":"10.1111\/ans.18196"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11023-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-11023-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11023-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T14:55:13Z","timestamp":1786200913000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-026-11023-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["11023"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-11023-z","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8067937\/v1","asserted-by":"object"}]},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]},"assertion":[{"value":"9 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study received approval from the Siriraj Institutional Review Board (Si-555\/2023). Written informed consent was obtained from all participants prior to enrollment.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"776"}}