The aim of this study was the examination of the metabolism and mechanism of action of D-pantothenyl alcohol in patients with postoperative intestinal atony. Seven metabolically healthy patients were examined on the 4th day following colorectal surgery, before bowel activity had started. Increased urinary excretion of the vitamin pantothenic acid was noted following the intravenous application of 2 gm of D-pantothenyl alcohol. Ten to 30% of the administered dose D-pantothenyl alcohol is excreted in the urine as pantothenic acid within 24 h. Simultaneously, the urinary excretion of beta-alanine, a pantothenic acid component, is increased. D-pantothenyl alcohol was metabolized to pantothenic acid in all the patients examined. Pantothenic acid is a component of coenzyme A, a key substance in the intermediary pathway of metabolism. Coenzyme A plays a role in the synthesis of acetylcholine from choline (a co-enzyme of cholinacetylase). Peristalsis induced by D-pantothenyl alcohol may be due to the increased synthesis of coenzyme A and acetylcholine in the autonomic nerve plexus of the intestinal tract.