Chewing gum for declining ileus and accelerating gastrointestinal recovery after appendectomy

Abstract

Original articleother problems such as the hospital-acquired infections are major concerns. 3 Postoperative ileus occurs due to the drop of intestinal movement and the reduction of the activity of the parasympathetic nervous system. 4 Ileus occurs in cases of opioid and drug interaction and abdominal operations, especially in surgeries with extreme manipulation, and transiently contribute to impeding peristalsis (bowel movement); the related mechanism is possibly dysfunction in the parasympathetic system (inhibitory neurons) activity. 5 Postoperative ileus increases to be a cause of morbidity and the primary reason for the extended hospital Abstract: Objective: Ileus usually occurs after abdominal surgery and is allied with complication and delays recovery. It is hypothesized that chewing gum reduces postoperative ileus by improving early recovery of gastrointestinal function. This study aimed to explore whether chewing gum after appendectomy accelerates the recovery of gastrointestinal function. Methods: Randomized control trial was used in this study. This study was conducted in the General Surgery Department at Zagazig University Hospital. A total of 240 patients undergoing appendectomy were involved in this study; they were divided into the chewing sugar-free gum group (120) and the control group (120). Two tools were utilized in this study. Tool I: Structured Interviewing Schedule: part 1: assessment of personnel characteristics. Part 2: assessment of anthropometric measurements of the studied subjects as well as pre-and intraoperative indicators of them. Tool II: postoperative assessment sheet: assessed postoperative parameters of the intestinal function, occurrence of postoperative ileus, and related symptoms were assessed among studied participants.Results: There were highly significant statistical differences in the time of resumption of gastrointestinal functions and postoperative ileus symptoms between the two groups (P<0.001), which was significantly shorter in the chewing gum group compared to the control group. Conclusions: The use of chewing gum is a useful and cheap method that can be employed to cut down the time to recover and accelerate normalization of gastrointestinal function. Chewing sugar-free gum after abdominal surgery is recommended to be added to the protocol of nursing care in the surgery units as well as its involvement in the nursing curriculum.

The effect of gum chewing on postoperative ileus in open colorectal surgery patients: A review

“…These studies vary in the intervention implementation in relation to chewing gum. Kalyanwat et al (2018), for example, instructed participants to chew gum four times a day for 40min each time, whilst Mahmoud and Mohammad (2018) instructed their participants to chew gum every 2h for 15min every time. In the study by Yang et al (2018), participants chewed gum three times a day for 30min, which is the lowest duration and frequency of gum chewing among the included studies.…”

“…In both the studies by Kalyanwat et al’s (2018) and Mahmoud and Mohammad (2018), the main limitation was that the researchers and health care personnel were not blinded, possibly introducing risk of bias in treating participants and outcome measurement. In both cases, allocation to treatment and control group was carried out following surgery, and participant allocation was performed by alternate sequence, which is considered an inadequate type of randomisation, leading to selection bias (Higgins & Green 2006).…”

“…The trials published after these reviews, and included in the present one, reported more positive postoperative outcomes with gum chewing. Kalyanwat et al (2018) reported a significant decrease in length of hospital stay, and Mahmoud and Mohammad (2018) and Yang et al (2018) reported a significant reduction in all paralytic ileus-related outcomes with gum chewing. The results of all three trials should, however, be interpreted with caution because they all include unclear to high risk of bias and other limitations.…”

Effect of Gum Chewing on Recovery After Surgery for Colorectal Surgery Patients

“…Among the interventions intended to increase early bowel activity after surgery, early feeding has been proven to shorten the time until the start of intestinal motility and first flatus. It reduces the risk of infection, and length of hospital stay (Asao et al, 2002;Gustafsson et al, 2013;Gnanarani, Mathew, & Venkatesan, 2018;Mahmoud, & Mohammad, 2018). Chewing gum has been described as some sort of "sham feeding" because even though there is chewing activity, no food is actually delivered to the stomach (Asao et al, 2002).…”

Effect of Sham Feeding on Postoperative Clinical Outcomes among Patients Undergoing Elective Abdominal and Gynecological Surgeries

“…Moreover, Mahmoud and Mohammad (2018) [31] mentioned that the findings of their study indicated that there were significant statistical differences between the study group and control groups regarding the mean time of the onset of bowel sound, the onset of the gas passage, the first defecation, the first feeling of hunger, and the length of hospital stay was significantly lower in the study group than in the control group.…”