Clinical Outcome of Chewing Gum on Bowel Motility Among Patients Undergoing Abdominal Surgery

Abstract

distension, lack of bowel sounds, and lack of passage of flatus or stool, worsened by postopera ve pain, nausea and vomi ng, delay in resuming enteral nutri on, and prolonged hospitaliza on. Other postopera ve complica ons include decondi oning, malnutri on, increased risk of nosocomial infec ons and pulmonary complicaons, decreased pa ent sa sfac on and increased health care costs [2,3]. In India, 60 to 70% of pa ents with major abdominal surgery develop complica on due to postopera ve ileus which leads to discomfort, prolonged hospital stay and economic burden [4]. Postopera ve ileus is managed by gastric decompression through Ryle's tube, keeping the pa ent nil per orally, intravenous fluid supplementa on ll ileus resolves, and pa ent passes flatus [5]. There are many nonpharmacologic treatment such as early enteral nutri on, early mobiliza on, laparoscopic surgery, psychological preopera ve prepara on among ABSTRACT Introduc on: Postopera ve paraly c ileus is one of the commonest causes of morbidity in abdominal surgeries. The aim of the present study was to evaluate efficacy of chewing gum in on bowel mo lity among pa ents who have undergone abdominal surgery. Methods: The details of pa ents along with diagnosis, co-morbidi es, dura on of anesthesia & surgery and post-opera ve stay were recorded. Pa ents that received chewing gum in addi on to standard postopera ve care were grouped as cases while those that received standard postopera ve care were grouped as controls. The pa ents were observed for Peristal c Sounds, Flatus passed, Stool Passed, return of appete and me was recorded. Results: The study was conducted with 200 pa ents of which 100 each were grouped as cases and controls. Majority of the pa ents in Cases Group were in the age group of 40-50 years (42%). The mean age of the pa ents was 47.3±12.97 years. 7 (23.3%) pa ents in Cases Group had hypertension while 5 (16.7%) paents had diabetes mellitus. 8 (26.8%) pa ents in Control Group had hypertension while 4 (13.4%) pa ents had diabetes mellitus. 47 (47%) pa ents in Cases Group had enterocolon diseases while 43 (43%) and 10 (10%) pa ents had hepatobiliary and pancrea c diseases respec vely. 46 (46%) pa ents in Control Group had enterocolon diseases while 45 (45%) and 9 (9%) pa ents had hepatobiliary and pancrea c diseases respec vely. There was no sta s cal significance on comparison between the groups with respect to age, sex, co-morbidi es and diagnosis. The mean dura on of induc on of anesthesia was 27.08±0.89 minutes and 28.16±1.14 minutes in Cases and Control Group respec vely. The mean dura on of surgery was 2.67±0.21 hours and 2.44±0.19 hours in Cases and Control Group respec vely. The mean dura on of return of Bowel Sound was significantly lesser in Cases Group as compared to Control Group (9.9±1.37 vs. 36.1±6.72 hours). The mean dura on of first passage of flatus was significantly lesser in Cases Group as compared to Control Group (14.8±2.13 vs. 81.1±5.47 hours). The mean dura on of me to first faeces was significantly lesser in Cases Grou...