Effect of chewing gum on bowel motility in post operative patients following abdominal surgery: a clinical outcome based study

Abstract

Background: 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.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.

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

“…When the discharge times of patients were compared, it was determined that discharge times of the experimental group patients were 34.5 hours earlier then the control group patients (Table 3). In a study by Kumar et al (2018) with patients who had undergone abdominal surgery, the average hospital stay was determined to be 11.9 days for the gum-chewing group, while it was 12.6 days for the non-gum-chewing group, which shows similar findings to ours.…”

“…Factors such as fluid-electrolyte imbalance, delayed feeding, the use of general anesthetics and narcotic analgesics, and an increase in post-operative sympathetic activity due to stress cause abdominal distention. Stressors such as post-operative pain, suppressing the urge to defecate, and the use of bedpans cause stress responses, and as a result, can cause abdominal distention (Asao et al, 2002;Kumar, Kumari, Kumar, & Raj, 2018).…”

Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

“…[ 142 143 ] Another meta-analysis of 12 studies and other RCTs have found the results to be equivocal (LOE- Low to Moderate). [ 144 145 146 147 ]…”