Chewing gum for enhancing early recovery of bowel function after caesarean section

Morais, Edna Pereira Gomes de; Riera, Rachel; Porfírio, Gustavo José Martiniano; Macedo, Cristiane R; Vasconcelos, Vivian Sarmento; Pedrosa, Alexsandra de Souza; Torloni, Maria Regina

doi:10.1002/14651858.cd011562

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…More recent meta-analysis suggested that gum-chewing in the immediate postoperative period after a cesarean section is a well tolerated intervention that enhances early recovery of bowel function. [24] However, as to the effect of gum-chewing after colorectal resection, the results remained inconsistent based on the latest studies [25,26] .…”

Section: Discussionmentioning

confidence: 99%

Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer

Zhao

Lin

et al. 2017

Medicine

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Background:In some studies, gum-chewing was demonstrated to have a beneficial effect on resumption of bowel function; however, other contradictory findings in other studies refute the effects of gum-chewing on peristaltic movements and digestive system stimulation. In addition, most previous studies were after colorectal or gynecology surgery, whereas few reports focused on the effect of gum-chewing after gastrectomy. The aim of this randomized controlled trial was to assess the effectiveness of gum-chewing on postoperative bowel function in patients who had undergone laparoscopic gastrectomy.Methods:From March 2014 to March 2016, 75 patients with gastric cancer received elective laparoscopic surgery in Shanghai Tongji hospital and were postoperatively randomly divided into 2 groups: 38 in a gum-chewing (Gum) group and 37 in a control (No gum) group. The patients in the Gum group chewed sugarless gum 3 times daily, each time for at least 15 minutes, until the day of postoperative exhaust defecation.Results:The mean time to first flatus (83.4 ± 35.6 vs. 79.2 ± 24.2 hours; P = 0.554) and the mean time to first defecation (125.7 ± 41.2 vs. 115.4 ± 34.2 hours; P = 0.192) were no different between the no gum and Gum groups. There was also no significant difference in the incidence of postoperative ileus (P = 0.896) and postoperative hospital stay (P = 0.109) between the 2 groups. The postoperative pain score at 48 hours (P = 0.032) in the Gum group was significantly higher than in the no gum group. There was no significant difference between the 2 groups in regards to patient demographics, comorbidities, duration of surgery, complications, and nausea/vomiting score.Conclusion:Gum-chewing after laparoscopic gastrectomy did not hasten the return of gastrointestinal function. In addition, gum-chewing may increase patient pain on the second postoperative day.

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Section: Discussionmentioning

confidence: 99%

Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer

Zhao

Lin

et al. 2017

Medicine

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“…The ERAS protocol for cesarean delivery includes postoperative gum chewing 18 because it can stimulate bowel function and increase peristalsis 29 . Findings from a 2016 Cochrane review showed that patients who chewed gum experienced the first passage of flatus and stool earlier than patients who did not chew gum (ie, seven and nine hours respectively), and that gum chewing reduced the rate of ileus occurrence more than 60% 30 . However, the review authors noted that the quality of evidence related to gum chewing was low and very low.…”

Section: Literature Reviewmentioning

confidence: 99%

Quality Improvement Project to Reduce Opioid Use in Patients Undergoing Cesarean Birth

Eldridge¹,

Martin²,

Campbell³

et al. 2022

AORN Journal

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After observing the effectiveness of Enhanced Recovery After Surgery (ERAS) protocols for gynecological surgery patients, an interdisciplinary team initiated a quality improvement project with an ERAS protocol to minimize opioid use of patients undergoing elective cesarean birth. Secondary outcomes during the three‐month project included decreasing the patient’s length of stay and inpatient care costs. We used the Lean Six Sigma methodology and measured aggregated patient outcomes of opioid use, length of hospital stay, and total cost. In addition, we incorporated the ERAS protocol into the electronic health record. Results showed a reduction use of morphine milligram equivalents of opioids, a slight decrease in length of hospital stay, and no change in the inpatient costs. The team recognized that implementation of an ERAS protocol is a best practice to reduce opioid use in patients undergoing a cesarean birth and decided to permanently include it in patient care processes.

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“…The PROSPERO registry of systematic reviews can provide transparency in the process and accountability for the study, and prevent unintended duplication of reviews. Unfortunately, as demonstrated by the recent publication of five systematic reviews on the use of chewing gum after Cesarean section, all showing a benefit and none yet having a noticeable impact on clinical practice, the availability of a platform for prospective registration of review protocols does not yet preclude research waste in this area. The impact of any tool is dependent on its uptake by researchers and, clearly, use of the PROSPERO registry is not yet fully established.…”

Section: The Problem Of Research Waste In Obstetricsmentioning

confidence: 99%

Increasing value and reducing research waste in obstetrics: towards woman‐centered research

Townsend

Duffy

Khalil

2020

Ultrasound in Obstet & Gyne

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Chewing gum for enhancing early recovery of bowel function after caesarean section

Cited by 9 publications

References 39 publications

Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer

Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer

Quality Improvement Project to Reduce Opioid Use in Patients Undergoing Cesarean Birth

Increasing value and reducing research waste in obstetrics: towards woman‐centered research

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