Gum chewing stimulates early return of bowel motility after caesarean section

Abstract

Objective: To evaluate the efficacy and safety of postoperative gum chewing on the recovery of bowel motility after caesarean section.

Design: A randomised controlled study.

Setting: Faculty of Medicine, Ain Shams University, Egypt.

Population: A total of 200 pregnant women delivered by elective caesarean section (CS) under general anaesthesia.

Methods: Women were randomised into two groups; group A (93 women) who received one stick of sugarless gum for 15 minutes every 2 hours after surgery, and group B (107 women) had traditional management (oral intake of clear fluids allowed after passage of flatus and regular diet with the passage of bowel movement).

Main outcome measures: Time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement and length of hospital stay.

Results: The mean duration of surgery was longer in group A (41.3 +/- 7.5 versus 38.4 +/- 8.1 minutes, P < 0.05). The mean postoperative time interval to first hearing of normal intestinal sounds (10.9 +/- 2.7 versus 15.6 +/- 3.7 hours), passage of flatus (17.9 +/- 4.6 versus 24.4 +/- 7.1 hours), defecation (21.1 +/- 4.7 versus 30 +/- 8.2 hours) and discharge from the hospital (40.8 +/- 10.6 versus 50.5 +/- 8.9 hours) were significantly shorter in group A (P < 0.001). Severe ileus occurred only in one woman belonging to group B. All patients in group A tolerated gum chewing beginning on the first postoperative day.

Conclusion: Gum chewing after CS is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stay; with potential impact on reducing the overall healthcare costs in case of routine implementation.