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

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

The Role of Chewing Gum on Post-operative Bowel Recovery after Gynecological Laparoscopic Surgery: A Short Report and Updated Review

“…A recent systematic review of chewing gum after gynecological surgeries was published in 2018, extracting the data from 10 RCTs; eight studies of laparotomy and two studies of laparoscopy [29]. As of May 2021, we have recorded two additional clinical trials for chewing gum as post-operative treatment in gynecological laparoscopy [1], [25], as presented in Table 4. Those studies revealed that chewing gum increased the recovery time of gastrointestinal function.…”

“…Before the study, all patients were asked for written informed consent, and the ethical clearance had been approved by the Review Ethic Committee of RSUD Arifin Achmad (01/2021). A total of 60 women, aged 23-42 years old and receiving gynecological laparoscopic surgery under general anesthesia, participated in this study following the previously described procedure [1]. The participants were divided equally into intervention groups (gum) and control groups.…”

“…Patients are undergoing abdominal surgery experience a reduction of gastrointestinal peristalsis, delaying the routine defecation that lasts for 3-5 days [1], [2]. This common abdominal surgery complication, post-operative ileus (POI), has been reported to be a notable economic burden [3], even equal to that of serious complications [4].…”

Nutrition Care Process of Surgical Patients in the Context of Enhanced Recovery After Surgery

“…These are the results of increasing the serum concentration of the peptide hormone gastrin, neuropeptide neurotensin, pancreatic polypeptide, and duodenal alkaline secretion. 77,78 The results suggested that chewing gum tricks the body into thinking it is eating, causing the digestive system to start working again. Because many patients cannot tolerate a diet immediately after abdominal surgery, few doctors encourage the patients to eat immediately after surgery.…”

“…The action of chewing gum can be seen as sham feeding, which activates the cephalovagal pathway, which increases the promotability of neural and humoral factors that act on different parts of the gastrointestinal tract. These are the results of increasing the serum concentration of the peptide hormone gastrin, neuropeptide neurotensin, pancreatic polypeptide, and duodenal alkaline secretion 77,78 . The results suggested that chewing gum tricks the body into thinking it is eating, causing the digestive system to start working again.…”