Influence of Gum Chewing on Postoperative Bowel Activity after Cesarean Section

Abstract

Objective: To assess the effects of gum chewing on postoperative bowel function after cesarean section. Material and Methods: Women who underwent cesarean section were randomized to either a gum-chewing group (n = 74) or a non-gum-chewing group (n = 76). The two groups were compared with respect to the return of bowel activity, postoperative analgesic and antiemetic drug requirement and postoperative hospital stay. Results: Bowel sounds appeared in a significantly shorter duration of time in the study group, the mean being 5.9 h as compared to 6.7 h in the control group (p < 0.01). The first passage of flatus postoperatively was 22.4 h in the gum-chewing group and 31 h in the control group (p < 0.001). The total length of hospital stay was shorter in the gum-chewing group (2.1 days) than in the control group (2.3 days), but it was not statistically significant (p > 0.05). Postoperative analgesic requirement in both groups was similar, but the postoperative antiemetic need in the gum-chewing group was lower than in the control group (p < 0.01). Conclusion: On the basis of the tolerability and results on bowel function, gum chewing provides a simple method for early recovery of bowel function after cesarean section.

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

“…The studies were generally of moderate quality with minimal publication bias. We evaluated the risk of bias in the 14 published RCTs [13,14,17,21,22,23,24,25,26,27,28,29,30,31](fig. 1) by the Cochrane Risk of Bias Tool [18].…”

“…(2) Patients that needed premedication, nasogastric tubes and drains, and those with medical disorders of pregnancy, antepartum hemorrhage, postpartum hemorrhage necessitating blood transfusion, delay in recovery from anesthesia, or need for intensive care postoperatively were excluded [17]. …”

The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section

“…For example, in previous studies, the time to first bowel sounds in gum-chewing groups ranged from 6.0 to 20.9 hr (Abd-El-Maeboud et al, 2009;Harma et al, 2009;Kafali et al, 2010;Mohsenzadeh Ledari et al, 2013;Satij & Cohen, 2006;Shang et al, 2010), and the time to first flatus ranged from 17.9 to 34.6 hr (Abd- ElMaeboud et al, 2009;Harma et al, 2009;Kafali et al, 2010;Mohsenzadeh Ledari et al, 2013;Satij & Cohen, 2006;Shang et al, 2010). The generally faster recovery of first bowel sounds and flatus in our study may be partly explained by all of our participants having received regional anesthesia, which results in a shorter time to the first passage of flatus than general anesthesia (Kafali et al, 2010;Liu et al, 2009). Another possible explanation for these differences is the use of different types of postsurgical analgesia.…”

Chewing reduces sympathetic nervous response to stress and prevents poststress arrhythmias in rats

“…Recent clinical investigations have demonstrated that gum chewing reduces postoperative ileus after gastrointestinal surgery (22,26) and cesarean section (1,23). Since sympathetic hyperactivity is one of the factors that promotes postoperative ileus (33), chewing may contribute to maintaining visceral autonomic balance and gastrointestinal homeostasis.…”