Chewing gum and postoperative ileus in adults: A systematic literature review and meta-analysis

Su’a, Bruce; Pollock, Terina T.; Lemanu, Daniel P.; MacCormick, Andrew D.; Connolly, Andrew B.; Hill, Andrew

doi:10.1016/j.ijsu.2014.12.032

Cited by 63 publications

(49 citation statements)

References 26 publications

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“…Furthermore, complication rates between these two types of surgeries differ significantly. Results from this trial provide similar results to other RCTs 2 4. However, this RCT included chewing gum before surgery, albeit only for 3 h. Investigating the duration of effect and possible dose–response for the anti-inflammatory effect of chewing gum is an intriguing avenue for further investigation.…”

Section: Commentarysupporting

confidence: 66%

“…Chewing gum is hypothesised to exert an effect via reduction of postoperative inflammation through cephalic vagal activation. Although a number of systematic reviews and meta-analyses have been published, the role of chewing gum in POI still remains unclear 2. Additionally, with the advent of enhanced recovery after surgery (ERAS) protocols, which encourage early feeding, the use of chewing gum has become less clear.…”

Section: Contextmentioning

confidence: 99%

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Perioperative use of chewing gum affects the inflammatory response and reduces postoperative ileus following major colorectal surgery

Su’a

Hill

2015

Evid Based Med

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Section: Commentarysupporting

confidence: 66%

Section: Contextmentioning

confidence: 99%

Perioperative use of chewing gum affects the inflammatory response and reduces postoperative ileus following major colorectal surgery

Su’a

Hill

2015

Evid Based Med

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“…The efficacy of gum chewing have been fully elucidated in the intestinal function recovery in patients after colorectal surgery and it can provide various benefits [10, 11], yet the efficacy of chewing gum after caesarean section remain inconsistent. Several previous meta-analysis [12–17] including randomized controlled trials (RCTs) on the gum using after caesarean have been conducted, but the included data are rather limited.…”

Section: Introductionmentioning

confidence: 99%

Chewing gum for intestinal function recovery after caesarean section: a systematic review and meta-analysis

Wen

Shen

et al. 2017

BMC Pregnancy Childbirth

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BackgroundGum chewing has been reported to enhance the intestinal function recovery after caesarean section, current perspectives and practice guidelines vary widely on the use of gum chewing, more studies on the role of gum chewing after caesarean section are needed.MethodsWe performed a comprehensive, systematic meta-analysis of randomized controlled trials (RCTs) on the efficacy of gum chewing after caesarean section. Studies were identified by searching EMBASE et al database (until June 30, 2016). Summary odd ratios or weighted mean differences with 95% confidence intervals were calculated for each outcome with fixed- or random-effects model.ResultsTen RCTs with a total of 1659 women were included in our meta-analysis. Gum chewing provided significant benefits in reducing the time to first passage of flatus, first defecation, first bowel sound, first bowel movement and the length of hospital stay, but not in the time to first feeling of hunger.ConclusionsGun chewing hastens the intestinal function recovery after caesarean section and offers a safe and inexpensive option. High-quality and larger-scale RCTs are still warranted to clarify the role of gum chewing in intestinal function recovery after caesarean section.

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“…In the systematic review conducted by Su'a et al . () 12 RCTs were considered: 8 conducted over 549 undergoing colorectal procedures, 3 conducted over 350 patients undergoing gynaecological and obstetric procedures, and the study conducted by Choi et al . () over 64 patients undergoing RC.…”

Section: Resultsmentioning

confidence: 99%

“…However, as found in literature, many clinicians are reluctant to utilize this method, often delaying the administration of oral nutrition until the first flatus occur. One of the reasons behind this is the fear of complications, therefore in the last few years the interest for the utilization of chewing gum as simulated feeding has grown and it appears to reduce POI incidence (Su'a et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The use of chewing gum for postoperative ileus prevention in patients undergoing radical cystectomy

Boarin¹,

Villa

Monte

et al. 2017

Int J of Uro Nursing

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Does the postoperative use of chewing gum in patients undergoing radical cystectomy (RC) facilitate intestinal motility recovery, reduce intestinal recanalization times and decrease length of stay? Postoperative ileus is a temporary impairment of intestinal motility and a frequent complication after RC. It is characterized by abdominal distention and absence of bowel functions, with symptoms including nausea, vomiting, pain and cramps. This results in an increase in length of stay, patient discomfort and costs. Different studies investigated the efficacy of chewing gum use, as a form of simulated feeding, in accelerating the resolution of ileus after several abdominal surgical procedures. Considering the lack of specific studies, some other conducted in similar abdominal procedures were included in this literature review. Despite the diversity of type of surgery, all considered studies show for patients who received chewing gum, a significant reduction in the time of first flatus and faeces, a reduction in the time of first bowel movements; not all included studies instead have found a significant decreasing in morbidity and length of stay. The chewing gum use seems to be a simple and inexpensive way to enhance recovery of bowel function, although it is probably still a little known procedure. It is possible recommending the administration of chewing gum in patients after cystectomy, monitoring the effectiveness, upon the recognition of possible conditions that might contraindicate its use.

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Chewing gum and postoperative ileus in adults: A systematic literature review and meta-analysis

Abstract: Chewing gum offers only a small benefit in reducing time to flatus and time to passage of bowel motion following abdominal surgery. This benefit is of limited clinical significance. Further studies should be conducted in a modern peri-operative care environment.

Cited by 63 publications

References 26 publications

Perioperative use of chewing gum affects the inflammatory response and reduces postoperative ileus following major colorectal surgery

Perioperative use of chewing gum affects the inflammatory response and reduces postoperative ileus following major colorectal surgery

Chewing gum for intestinal function recovery after caesarean section: a systematic review and meta-analysis

The use of chewing gum for postoperative ileus prevention in patients undergoing radical cystectomy

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