Gum Chewing: Another Simple Potential Method for More Rapid Improvement of Postoperative Gastrointestinal Function

Abstract

Background: Sham feeding has been reported to enhance bowel motility. Here, to promote gastrointestinal function after postoperative ileus, the effect of gum chewing (GC) was evaluated. Methods: Literature search including PubMed, Embase, Science Citation Index, SpringerLink, and secondary sources. Fixed-effect and random-effects models were used to measure the pooled estimates. The test of heterogeneity was performed with the Q statistic. Stratified and sensitivity analyses were performed to explore heterogeneity between studies and to assess effects of study quality. Results: GC was well tolerated in a total of 1,148 cases in this meta-analysis. The pooled weighted mean difference for time to first flatus and bowel movement in GC was found to be –9.21 (95% CI: –12.07 to –6.34; p < 0.01) and –11.42 (95% CI: –16.05 to –6.79; p < 0.01), respectively, compared to standardized postoperative care. The intervention also decreased length of hospitalization by 12.23 h (95% CI: –18.80 to –5.67; p = 0.0003). Subgroup analyses for different abdominal procedures all favored GC. Conclusion: This meta-analysis demonstrated that GC was safe and easily tolerated without any complications following abdominal surgery to potentially shorten postoperative ileus.

Perioperative use of chewing gum affects the inflammatory response and reduces postoperative ileus following major colorectal surgery

“…Furthermore, complication rates between these two types of surgeries differ significantly. Results from this trial provide similar results to other RCTs 2 4. However, this RCT included chewing gum before surgery, albeit only for 3 h. Investigating the duration of effect and possible dose–response for the anti-inflammatory effect of chewing gum is an intriguing avenue for further investigation.…”

Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial

“…Gum chewing, as a proxy of sham feeding, is a very simple way used to accelerate gut motility M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT recovery after surgical operation. Several trials have indicated its effectiveness in reducing the duration of postoperative ileus and hospital stay (2,3). Gastroenterologists have also investigated its effect on capsule endoscopy, and it is reported that chewing-gum can significantly decrease gastric transit time and small bowel transit time during capsule endoscopy, and it may improve the chance of capsule reaching the caecum without affecting image quality (4).…”

Meta-analysis comparing chewing gum versus standard postoperative care after colorectal resection

“…In order to determine the effect and safety of CG in patients undergoing colorectal surgery, 11 meta-analyses [8–18] have been published previously. The characteristics and outcomes of these all meta-analyses have been summarized in Table 2.…”

“…Previous systematic reviews [8–18] have been performed to address this issue, and shown that CG may be a safe and inexpensive approach to enhance return of intestinal function following colorectal resection and shorten the LOS. However, little attention had been paid on several important outcomes including time to first bowel sounds, time to first feeding, mortality, economic effect and quality of life (QoL) in these incomplete analyses [8–18].…”

“…However, little attention had been paid on several important outcomes including time to first bowel sounds, time to first feeding, mortality, economic effect and quality of life (QoL) in these incomplete analyses [8–18]. Furthermore, several randomized controlled trials (RCTs) with moderate or large sample size, which investigated the comparative efficacy of CG versus standard postoperative care protocols (SPCPs) in patients undergoing colorectal resection, have been published recently.…”