Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial

Matros, Evan; Rocha, Flavio G.; Zinner, Michael J.; Wang, John; Ashley, Stanley W.; Breen, Elizabeth; Soybel, David I.; Shoji, Brent; Burgess, Anne; Bleday, Ronald; Kuntz, Richard E.; Whang, Edward E.

doi:10.1016/j.jamcollsurg.2006.02.009

Cited by 96 publications

(117 citation statements)

References 20 publications

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“…p value of 0.005,0.011 and 0.019 respectively which is significant. This finding was similar to the study of Matros, E et al, [6] in which the cases of gastric surgeries recovered early.…”

Section: Discussionsupporting

confidence: 92%

“…The published literature reveals that gum chewing in the postoperative period is a safe method to stimulate bowel motility and it has been shown to reduce ileus and helps to resume early bowel functions normally. [6] AIMS AND OBJECTIVES: Analysis of clinical outcome of effect of chewing gum on bowel motility in post-operative patients following abdominal surgery. To assess the effectiveness of chewing gum chewing in early return of bowel function after abdominal surgery in Hamidia Hospital at Bhopal and To assess the return of bowel function with and without chewing gum after abdominal surgery and compare different variables.…”

mentioning

confidence: 99%

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Analysis of Clinical Outcome of Effect of Chewing Gum on Bowel Motility in Post - Operative Patients Following Abdominal Surgery

Khobragade¹,

Chaudhary²,

Songra³

2015

jemds

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INTRODUCTION:One very important complication of abdominal surgeries is postoperative ileus which results in severe patient discomfort, prolonged hospitalization, and enhanced treatment cost. This study was conducted with an aim to analyze the clinical outcome of effect of chewing gum mainly to avoid post-operative paralytic ileus in post-operative patients of abdominal surgeries. MATERIAL AND METHODS: In this study total 200 patients were included, 100 were cases and remaining were controls. The cases were given chewing gum to chew after the surgery while the controls were allowed to heal without chewing gums in conventional style and both were observed hourly for clinical outcome. RESULTS: Among cases the mean duration of first sound heard was 26.3 hours while among controls this was 38.8 hours [p<0.001], the mean duration of first flatus passed among cases was 50.7 hours while that among controls was 68.5 hours, the mean duration of first Bowel passed among cases was 92.4 hours while that among controls was 128.3 hours [p<0.001]. On comparing cases of routine with emergency surgeries, gastric with small bowel surgeries, and traumatic with pathological bowel surgeries it was observed that the first bowel sound, first flatus and first bowel passed appears significantly earlier in routine surgeries, gastric surgeries and traumatic surgeries respectively. CONCLUSIONS: It was observed that chewing gum has significant effect over bowel motility as bowel sounds appeared significantly earlier in cases than control and time for first flatus passed and first bowel passed were also noted significantly earlier in cases than controls. Hospital stay of cases were found significantly lesser than control hence simple intervention like chewing can decrease the burden of disease of paralytic ileus from community.

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“…p value of 0.005,0.011 and 0.019 respectively which is significant. This finding was similar to the study of Matros, E et al, [6] in which the cases of gastric surgeries recovered early.…”

Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Analysis of Clinical Outcome of Effect of Chewing Gum on Bowel Motility in Post - Operative Patients Following Abdominal Surgery

Khobragade¹,

Chaudhary²,

Songra³

2015

jemds

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“…These excluded articles were letters to the editor concerning one already included article [22,23,24]. The remaining four articles were RCTs [25,26,27,28]. Using the ‘related article’ feature in PubMed, another RCT was found, resulting in a total of five RCTs for analysis [25,26,27,28,29].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of the Efficacy of Gum Chewing for the Amelioration of Postoperative Ileus

et al. 2008

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Background: Recent trials have shown promising results for the efficacy of gum chewing for the amelioration of postoperative ileus. This finding could have a major clinical impact since gum chewing is relatively harmless and cheap while postoperative ileus has a significant impact on healthcare. Methods: Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of gum chewing after colorectal surgery to a standard control for the amelioration of postoperative ileus, expressed as time to flatus, time to defecation and overall hospital stay. Results: Five randomized controlled trials with a total number of 158 patients were found. The studies were homogeneous and a meta-analysis was performed. The pooled weighted mean difference (WMD) of time to flatus was significantly shorter for the gum-chewing group (20 h with a 95% confidence interval (CI) of 13–27). The pooled WMD of time to defecation was significantly shorter (29 h, 95% CI of 19–39). There was a non-significant trend towards a shorter postoperative hospital stay (1.3 days shorter, 95% CI of 3.2 days shorter to 0.6 days longer). Conclusion: This meta-analysis shows a favorable effect of gum chewing on time to flatus and defecation but no significant effect on the hospital stay.

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“…75 A number of studies exist which demonstrate the benefits in patients undergoing colorectal surgery. 73,74,[76][77][78] A meta-analysis of several RCTs evaluating the effect of chewing gum on postoperative ileus has subsequently been published. Although there are relatively low patient numbers and a significant heterogeneity of studies, chewing gum offers significant benefits by reducing the time to pass flatus and the time until first bowel movement.…”

Section: Prevention Of Prolonged Postoperative Ileusmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

263

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial

Cited by 96 publications

References 20 publications

Analysis of Clinical Outcome of Effect of Chewing Gum on Bowel Motility in Post - Operative Patients Following Abdominal Surgery

Analysis of Clinical Outcome of Effect of Chewing Gum on Bowel Motility in Post - Operative Patients Following Abdominal Surgery

A Systematic Review of the Efficacy of Gum Chewing for the Amelioration of Postoperative Ileus

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

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