To learn how effective water-soluble contrast (WSC) is in relieving adhesive small bowel obstruction (SBO) was the purpose of this study. Adhesive SBO can be treated non-surgically with WSC since it is cathartic. Unfortunately, there is a lack of unifying evidence in favor of this method. Articles published between January 1,1990, and October 31, 2021, describing the effect of WSC compared with control therapies were systematically reviewed, and a meta-analysis was performed. 

The Cochrane risk-of-bias and Newcastle-Ottawa scales were used to evaluate the quality of the studies. Nonsurgical patients who received WSC had their treatment efficacy evaluated by analyzing their operation rates and hospital length of stay (HLOS) in the hospital. A total of 4,879 items were found during the initial search; however, only 28 were chosen for further examination. There were 11 eligible randomized controlled trials RCTs with 817 patients and 9 observational studies with 3,944 people who met the criteria. The RCTs found a 1.95-day reduction in HLOS for nonsurgical patients (95% CI, 0.56-3.3), while the observational studies could not measure this effect. 

However, in observational studies, WSC considerably decreased surgical rates (11% vs. 16%, risk ratio: 0.56, 95% CI: 0.39-0.82), despite having no effect on operating rates in RCTs (19.8% vs. 21.4%). Patients with SBO who do not need surgery may benefit from WSC research regarding shorter HLOS. However, the existing literature is disjointed and has serious design flaws. To fully ascertain the benefit of WSC for the management of SBO, high-quality RCTs conducted according to defined protocols are required.