Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial

Abstract

Postoperative ileus is one of the common problems after abdominal surgeries. It contributes to delayed recovery and prolongs hospital stay. Sham feeding, such as gum chewing, may accelerate return of bowel function and reduce morbidity and length of hospital stay. This study aimed to determine whether gum chewing in the immediate postoperative period facilitates a return to bowel function in cesarean-delivery patients. Three hundred eighty-eight patients who underwent cesarean delivery were randomly assigned to a gum-chewing group (group G, N = 193) or a control group (group C, N = 195). Demographic data, duration of surgery, type of anesthesia, and time of discharge from hospital were recorded. Patients in the gum-chewing group chewed gum three times per day as soon as returning from the operating theater to the ward until the time they defecated or were discharged. Patients were asked to chew gum at least half an hour each time. The T test and Pearson chi-square test was used for statistical analysis. Groups were comparable in age, weight, height, weeks of gestation, duration of surgery, and type of anesthesia. Bowel sounds were 5 hours earlier in the gum-chewing group (mean 18.2 hours) than in the control group (mean 23.2 hours). Passing flatus was 5.3 hours earlier in group G (mean 34.6 hours) than in group C (mean 39.9 hours). Patients having mild ileus symptoms were 9% less in group G (mean 12%) than in group C (mean 21%). The difference between the two groups were all highly significant (p < 0.001). Gum chewing was easily tolerated without any complications. Gum chewing is an inexpensive, convenient, and physiological method in enhancing the recovery of bowel function. But this may not facilitate early hospital discharge, lactation, or defecation.