Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery

Binti Bhatiyani; Pandeeswari .; Dolly Bhasani; Shrikant Dhumale

doi:10.18203/2320-1770.ijrcog20180187

Authors

Binti Bhatiyani Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri East, Mumbai, Maharashtra, India
Pandeeswari . Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri East, Mumbai, Maharashtra, India
Dolly Bhasani Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri East, Mumbai, Maharashtra, India
Shrikant Dhumale Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri East, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20180187

Keywords:

Chewing gum, Gastrointestinal function, Postoperative ileus

Abstract

Background: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15%. Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of the hospitalisation period. This study aims to investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynaecologic surgery.

Methods: 101 women who underwent laparoscopic surgery for benign gynaecological conditions under general anaesthesia were recruited. 50 patients received sugar free chewing gum post operatively and the outcomes were compared with the control group. The study’s primary end points were the time to first regular bowel sounds and time to passage of flatus after surgery. Secondary end points were the time to first defecation, patient satisfaction, and potential side effects of postoperative gum chewing.

Results: We found a significantly shorter interval between surgery and passage of flatus in the intervention group (median 10 hours compared with 13 hours p=0.0151) and a significantly higher rate of regular bowel sounds 3 hours (74% compared with 45%; p= 0.003) and 5 hours after surgery (91% compared with 78%; p=0.01). There was no significant difference in time to first defecation between groups (median 18 hours compared with 20 hours; p=0.222).

Conclusions: Gum chewing seems to have beneficial effects on bowel motility when used in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynaecological laparoscopic surgery

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References

Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG 2009;116:1334-9.

Kafali H, Duvan CI, Gözdemir E, Simavli S, Onaran Y, Keskin E. Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest. 2010;69:84-7.

Jang SY, Ju EY, Kim DE, Kim JH, Kim YH, Son M, et al. First flatus time and xerostomia associated with gum-chewing after liver resection. J Clin Nurs. 2012;21:2188-92.

Schuster R, Grewal N, Greaney GC, Waxman K. Chewing reduces ileus after elective open sigmoid colectomy. Arch Surg. 2006;141:174-6.

Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg. 2009;13:649-56.

Asao T, Kuwano H, Nakamura JI, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002;195:30-2.

Choi H, Kang SH, Yoon DK, Kang SG, Ko HY, Moon du G, et al. Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study. Urol. 2011;77:884-90.

Husslein H, Franz M, Gutschi M, Worda C, Polterauer S, Leipold H. Postoperative gum chewing after gynecologic laparoscopic surgery. Obstet Gynecol. 2013122:85-90.

Craciunas L, Sajid MS, Ahmed AS. Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta-analysis of randomized controlled trials. BJOG. 2014;121:793-800.

Park SY, Chung M. Can gum chewing reduce postoperative ileus after open abdominal surgery. Ann Surg Treatment Res. 2009;7:306-9.

Fanning J, Valea FA. Perioperative bowel management for gynecologic surgery. Am J Obstet Gynecol. 2011;205:309-14.

Asao T, Kuwano H, Nakamura JI, Morinaga N, Hirayama I, Cide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002;195:30-2.

Su’a Bu Pollock TT, Lemanu DP, MacCornick AD, Connolly AB, Hill AG. Chewing gum and postoperative ileus in adults: a systemic literature review and meta-analysis. Int J Surg. 2015;14:49-55.

Ho YM, Smith SR, Pockneyp P, Lim P, Attia J. A meta-analysis on the effect of the sham feeding following colectomy: should gum chewing be included in enhanced recovery after surgery protocols. Dis Colon Rectum. 2014;57(1):115-26.

Keenahan M. Does gum chewing prevent postoperative paralytic ileus? Nurs. 2014;44:1-2.

Waldhausen JH, Schirmer BD. The effect of ambulation on recovery from postoperative ileus. Ann Surg. 1990;212:671-7.

Nimarta, Singh NV, Shruti, Gupta R. Effectiveness of chewing gum on bowel motility among the patients who have undergone abdominal surgery. Nur Midwifery Res J. 2013;9(3).