Effect of Tricholine Citrate and Sorbitol Solution in Post-Gastrointestinal Surgical Patients

Abstract

Background: Postoperative subacute intestinal obstruction (SAIO) is a clinically important complication following gastrointestinal surgery. Conservative management remains an important component of treatment. This study evaluated the clinical effectiveness and safety of tricholine citrate and sorbitol solution as an adjunct to conservative management in postoperative SAIO. Aim and Objective: To evaluate the clinical effectiveness and safety of tricholine citrate and sorbitol solution in patients with postoperative gastrointestinal surgical SAIO, with particular emphasis on symptom relief, restoration of bowel function, oral diet tolerance, and requirement for further intervention. Materials and Methods: A prospective cohort study was conducted in the Department of General Surgery, Government Medical College, Kota. The field/experimental work was conducted over 18 months within the approved project period. The approved project period was from 01 May 2023 to 30 April 2025. Adult patients with postoperative SAIO who met the predefined eligibility criteria were included. Patients with acute intestinal obstruction, severe hepatic or renal disease, allergy to the medication, unwillingness to participate, and age below 18 years were excluded. Patients received tricholine citrate plus sorbitol solution in addition to conservative management, including intravenous fluids, bowel rest, and electrolyte correction. Clinical symptoms, bowel function, oral diet tolerance, laboratory parameters, and treatment-related adverse events were assessed during follow-up. Results: A total of 100 patients were included in the detailed study analysis. The mean age was 44.1 ± 7.6 years, with males comprising 59% and females 41% of the study population. Vomiting was present in 84% of patients and showed statistically significant improvement (χ² = 6.25, p = 0.012). Abdominal tenderness was present in 12% of patients and demonstrated a statistically significant association with clinical improvement (χ² = 42.38, p < 0.00001). Bowel sounds were present in 100% of patients by Day 3 (χ² = 37.63, p < 0.00001). The mean pulse rate was 82.4 ± 6.3 beats/min and the mean serum lactate level was 1.49 mmol/L. ROC analysis demonstrated an AUC of 0.91. Overall, 72% of patients showed significant symptom improvement within 48–72 hours. The reported time to first passage of flatus was approximately 36 hours, compared with a reported average of 72 hours before improvement, and oral diet was tolerated at an average of 2.5 days. Mild bloating was reported in 5% of patients, with no major adverse effects recorded. Conclusion: Tricholine citrate and sorbitol solution, when used along with conservative management, was associated with improvement in clinical symptoms and bowel function in postoperative SAIO patients. The treatment was well tolerated, with no major adverse effects reported. Larger controlled studies are required to confirm these findings.

Keywords: Tricholine Citrate; Sorbitol; Subacute Intestinal Obstruction; SAIO; Gastrointestinal Surgery; Postoperative Intestinal Obstruction; Bowel Motility; Conservative Management; Serum Lactate.