Chewing gum for postoperative recovery of gastrointestinal function

A common consequence of abdominal surgery is that the patient’s digestive system stops working for a few days. This is called ileus and it can be both painful and uncomfortable for the patient.  Ileus can lead to nausea, vomiting, and abdominal discomfort and is associated with complications, reduced patient satisfaction, and increased length of hospital stay.

Chewing gum is hypothesized to reduce postoperative ileus by stimulating early recovery of gastrointestinal function. Chewing gum tricks the body into thinking it is eating, causing the digestive system to start working again. Given that most people have previous experience of chewing gum, the intervention is generally well tolerated by individuals. Chewing gum as an intervention is also low-cost and easy to implement.

A team of Cochrane authors, based in the UK and Denmark and working with the Cochrane Colorectal Cancer Group, set out to evaluate if chewing gum after surgery hastens the return of gastrointestinal function. Randomized controlled trials that used chewing gum as an intervention compared to a control group were included. In the review there were 81 studies that recruited 9072 participants. The studies mainly focussed on people having bowel surgery or caesarean section, but there were some studies of other surgery types. Many of the studies were rated at high or unclear risk of bias.

There was some evidence that people who chewed gum after an operation were able to pass wind and have bowel movements sooner than people who did not chew gum. There was also some evidence that people who chewed gum had bowel sounds (gurgling sounds heard using a stethoscope) slightly sooner. In some studies, those chewing gum reported reduced nausea and vomiting and other complications. There was a small difference in how long people stayed in hospital between people who did or did not chew gum. There was little difference in mortality, infection risk and readmission rate between the groups.

“Chewing gum is an innovative and low cost intervention. This review identified some evidence that chewing gum after surgery may help the patient’s digestive system to recover faster,” said Vaneesha Short, a researcher at the NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle in Bristol, and the lead author of the Cochrane Review. “We know that there are many factors that affect the onset of ileus. More high quality studies are needed to explore the effects of chewing gum after a variety of different types of surgery.”

Related resource

Read the Cochrane Review

Friday, March 13, 2015