Impact of gum chewing on recovery of bowel activity after caesarean section

Background: Childbirth is a memorable part in every woman’s life. Each labour experience is unique and calls for a celebration. Objective of this study was to evaluate the effect of gum chewing on recovery of bowel motility after caesarean section.Methods: This prospective randomized controlled trial was conducted on 220 women who had undergone cesarean section and were further sub-divided into two groups of 110 women each Group I (Study group, n=110) in whom chewing gum was advised postoperatively and Group II (Control group, n=110)  who were managed as per standard departmental postoperative feeding protocol.Results: Mean age in Group A women was 24.86±3.89 years and 25.28±3.34 years in Group B. There was no statistically significant difference between the study and control group regarding their age, parity, occupation, LSCS/previous abdominal surgery, type of cesarean section, indications of cesarean section, skin incision, intraperitoneal adhesions. The mean time of bowel sound appearance in Group A was 3.27±0.95 and it was 8.22±2.0 hours in Group B. The mean time of passage of flatus was found to be 9.77±3.21 hours in Group A and 7.15±3.07 hours in Group B. In Group A, the mean time of passage of stools was 18.79±4.23 hours and it was 39.12±6.56 hours in Group B. Mean duration of hospital stay was significantly lesser (3.23±0.60 days) in gum chewing group than in the non-gum chewing group (4.18±1.28 days).  Seventy-six (69.09%) women of Group A needed only one chewing gum before appearance of bowel sound / flatus / feces. Only three women required three chewing gums. Out of 31 cases, who required two chewing gums, five were of previous 1 LSCS and 12 were previous 2 LSCS, thus suggesting delayed return of gut motility in women with > 1 previous LSCS.Conclusions: It was evident that gum chewing, a form of sham feeding is considered as an effective and inexpensive method which hastens the return of gut motility after caesarean section.

Does gum chewing affect the timing of return of intestinal motility after elective cesarean section?

Background: The aim is to evaluate the effect of gum chewing on the return of intestinal motility after elective CS.Methods: Study period was from September 2017 to March 2018 at the Assiut Women Health University Hospital. The study was registered as a prospective cohort study (Clinicaltrial.gov   NCT03355378). Women planned for elective CS according to selection criteria randomized to two groups: Group 1: included 100 patients who received intraoperative and postoperative non-sugary gum chewing as 15 minutes every 2 hours post-operatively for 6 hours with regular care and Group 2: included 100 patients who received regular care without gum chewing.Results: No statistically significant difference regarding the baseline criteria of both groups. There was a statistically significant lower systolic and diastolic blood pressure in gum chewing group. Hospital stay of gum chewing group was 7.33±0.73 hours versus in non-gum chewing group 20.28 ± 9.92 (p=0.000). Passage of flatus of gum chewing group was 8.54±0.98 hours versus in non-gum chewing group 13.22 ± 3.75 (P= 0.000).Conclusions: Gum chewing during elective CS improves gut motility in a safe way resulting in early passage of flatus, less hospital stay, and minimal pain score less cost on hospitals.

Can Gum Chewing Reduce Postoperative Ileus after Open Abdominal Surgery?

PURPOSE: Gum chewing activates chephalic-vagal reflex as in food consumption and increases the release of gastrointestinal hormones which are related with gut motility. The objective of this study was to assess whether it is effective in shortening the time of hospitalization and postoperative ileus. METHODS: Twenty patients who received open abdominal surgery for colon cancer in Gachon University, Gil Hospital were collected. They were further categorized to gum-chewing group (n=10, mean age=52.0 years, range 37 to 70) and control group (n=10, mean age=59.7 years, range 35 to 75) randomly. The patients in the gum-chewing group chewed gum three times a day from the first postoperative AM until the day they began oral intake. The time of gas out was recorded in each group. RESULTS: The mean time of gas out were 2.35 days (SD 1.2) in gum-chewing group and 2.87 days (SD 1.2) in control group (P=0.41). The mean postoperative hospital days were 10.5 days in gum-chewing group and 13.0 days in control group (P=0.23). CONCLUSION: There were no statistically significant results for shortnening of postoperative ileus and hospital day in this study.