Gum Chewing Reduces Ileus After Elective Open Sigmoid Colectomy

Abstract

Hypothesis: Gum chewing after elective open colon resection may stimulate bowel motility and decrease duration of postoperative ileus. Design and Setting: Prospective, randomized study in a community-based teaching hospital. Patients: Thirty-four patients undergoing elective open sigmoid resections for recurrent diverticulitis or cancer. Main Outcome Measures: First feelings of hunger, time to first flatus, time to first bowel movement, length of hospital stay, and complications. Results: A total of 34 patients were randomized into 2 groups: a gum-chewing group (n=17) or a control group (n=17). The patients in the gum-chewing group chewed sugarless gum 3 times daily for 1 hour each time until discharge. Patient demographics, intraoperative, and postoperative care were equivalent between the 2 groups. All

Effects of Bit Chewing on Right Upper Quadrant Intestinal Sound Frequency in Adult Horses

“…In our study mastication of a bit consistently caused an increase in gut sounds detected with electronic auscultation on the right upper quadrant, as food administration did in a recent study [18].…”

“…Auscultation is clinically a fundamental tool to evaluate gut motility although there is a poor interobserver correlation [18]. Computer aided auscultation allow more objective analysis of gut sounds although some interobserver disagreement can still occur [18].…”

“…As previously described [18], a digital phonendoscope connected to a laptop and held by an operator was positioned in this area and the site marked with a permanent marker to ensure correct positioning at each examination.…”

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

“…75 A number of studies exist which demonstrate the benefits in patients undergoing colorectal surgery. 73,74,[76][77][78] A meta-analysis of several RCTs evaluating the effect of chewing gum on postoperative ileus has subsequently been published. Although there are relatively low patient numbers and a significant heterogeneity of studies, chewing gum offers significant benefits by reducing the time to pass flatus and the time until first bowel movement.…”

“…Schuster and colleagues estimated that the use of chewing gum following colectomy could save $118 828 000 per year in the United States. 76 However, few studies have examined the impact of introducing an ERAS program on quality of life or health economic outcomes in the months after surgery. The benefits of ERAS will be markedly reduced if the costs are simply transferred to the community or if patients suffer a greater deterioration in quality of life than is experienced with conventional care.…”