The Effect of Gum Chewing, Early Oral Hydration, and Early Mobilization on Intestinal Motility After Cesarean Birth

Şahin, Ethem; Terzioğlu, Füsun

doi:10.1111/wvn.12125

Cited by 28 publications

(17 citation statements)

References 44 publications

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“…The results of our study have found that chewing sugarless gum after caesarean section can significantly promote the recovery intestinal function by accelerating the time to first normal intestinal sounds, first passage of flatus, first defecation and shortening the length of hospital stay which went in agreement with many studies [17][18][19][20][21][22][23] .…”

Section: Discussionsupporting

confidence: 91%

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The Role of Gum Chewing in Regaining Bowel Motility in Patients Undergoing Cesarean Section: A randomized controlled trial

Shabaan

Dieb

2019

Evidence Based Women's Health Journal

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Background: Paralytic ileus is one of the problems that are faced following abdominal surgeries including caesarean section which leads to post-operative pain, abdominal distension, delayed oral feeding, prolonged hospital stay and increased hospital cost. Objective: To assess the effectiveness of chewing gum as safe, effective and easy option to compete paralytic ileus. Patients and Methods: One hundred sixty two parturient women who had caesarean section delivery under spinal anesthesia were recruited and randomly allocated to two groups; group A the study group which were allowed to chew sugarless gums two hours after caesarean section for 30 minutes and repeated every two hours till auscultation of normal intestinal sounds or passage of flatus. Group B the control group underwent conventional care which is nothing per oral till audible intestinal sounds or passage of flatus. It was difficult to apply complete blindness due to the study design so the physician is only blinded. The primary outcome is the time of auscultation of first normal intestinal sounds and the secondary outcomes are time of passage of flatus, stools. Results: Both groups were comparable regarding to their demographic data. There was a statistical significance difference between both groups regarding auscultation of first intestinal sounds, passage of flatus, passage of stools and postoperative hospital stay (P value 0.001, 0.001, 0.001 and 0.001, respectively). No statistical significance difference between both groups regarding presence of abdominal distension, postoperative vomiting, patient satisfaction and presence of obstetric complications. Conclusion: The routine use of gum chewing together with early ambulation and no use of narcotics following caesarean section offers a safe, easy, effective option for early resumption of intestinal function and consecutively associated with short hospital stay.

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Section: Discussionsupporting

confidence: 91%

“…A study by Terzioglu 2015, compared the impact of gum chewing, early oral hydration and early mobilization on recovery of intestinal motility after cesarean section found that all of them promoted intestinal movement, and can be applied during routine postoperative care to shorten hospitalion and avoid postoperative ileus [22] .…”

Section: Discussionmentioning

confidence: 99%

The Role of Gum Chewing in Regaining Bowel Motility in Patients Undergoing Cesarean Section: A randomized controlled trial

Shabaan

Dieb

2019

Evidence Based Women's Health Journal

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“…An earlier meta-analysis by Noble et al [ 13 ] identifying nine eligible trials also showed that chewing sugarless gum following elective intestinal resection was associated with improved outcomes, but the efficacy on a reduced rate of clinical complications or reduced cost was not confirmed, which is also in line with our findings. Other previous meta-analyses [ 38 – 44 ] that focused on the effects of gum chewing on the recovery of intestinal function after abdominal surgery (e.g., cesarean delivery) also confirmed the beneficial role of gum chewing after surgery. Currently, several RCTs with moderate or large sample size investigating the efficacy of chewing gum in patients undergoing colorectal resection have been published, however, which has not been included for synthesized analysis in the latest meta-analysis by Song et al [ 45 ].…”

Section: Discussionsupporting

confidence: 53%

Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis

Mei

Wang

Cui

et al. 2017

Gastroenterology Research and Practice

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Background This meta-analysis was performed to assess the efficacy and safety of chewing gum in intestinal function recovery after colorectal cancer surgery. Methods A systematic search was conducted in PubMed, Embase, Science Direct, and Cochrane library for relevant randomized controlled trials (RCTs) published until April 2017. Summary risk ratios or weighted mean differences with 95% confidence intervals were used for continuous and dichotomous outcomes, respectively. Results 17 RCTs with a total number of 1845 patients were included. Gum chewing following colorectal cancer surgery significantly reduced the time to first passage of flatus (WMD −0.55; 95% CI −0.94 to −0.16; P = 0.006), first bowel movement (WMD −0.60; 95% CI −0.87 to −0.33; P < 0.0001), start feeding (WMD −1.32; 95% CI −2.18 to −0.46; P = 0.003), and the length of postoperative hospital stay (WMD −0.88; 95% CI −1.59 to −0.17; P = 0.01), but no obvious differences were found in postoperative nausea, vomiting, abdominal distention, pneumonia, and mortality, which were consistent with the findings of intention to treat analysis. Conclusions Chewing gum could accelerate the recovery of intestinal function after colorectal cancer surgery. However, it confers no advantage in postoperative clinical complications. Further large-scale and high-quality RCTs should be conducted to confirm these results.

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“…A recent study [32] compared the effect of gum chewing, early oral hydration, and early mobilization on intestinal motility after cesarean birth, concluded that all of the three different interventions increased intestinal motility, and should be recommended during postoperative routine care to shorten hospital stay and prevent postoperative ileus, future research needs to further clarify the roles of those three interventions. Notably, one included RCT [24] also evaluated the effects of xylitol-containing and xylitol-free gum chewing on gastrointestinal recovery after cesarean section, the results indicated that xylitol-containing gum might be superior to xylitol-free gum, while the most included RCTs adopted the sugar-free gum in their interventions.…”

Section: Discussionmentioning

confidence: 99%

Chewing gum for intestinal function recovery after caesarean section: a systematic review and meta-analysis

Wen

Shen

et al. 2017

BMC Pregnancy Childbirth

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BackgroundGum chewing has been reported to enhance the intestinal function recovery after caesarean section, current perspectives and practice guidelines vary widely on the use of gum chewing, more studies on the role of gum chewing after caesarean section are needed.MethodsWe performed a comprehensive, systematic meta-analysis of randomized controlled trials (RCTs) on the efficacy of gum chewing after caesarean section. Studies were identified by searching EMBASE et al database (until June 30, 2016). Summary odd ratios or weighted mean differences with 95% confidence intervals were calculated for each outcome with fixed- or random-effects model.ResultsTen RCTs with a total of 1659 women were included in our meta-analysis. Gum chewing provided significant benefits in reducing the time to first passage of flatus, first defecation, first bowel sound, first bowel movement and the length of hospital stay, but not in the time to first feeling of hunger.ConclusionsGun chewing hastens the intestinal function recovery after caesarean section and offers a safe and inexpensive option. High-quality and larger-scale RCTs are still warranted to clarify the role of gum chewing in intestinal function recovery after caesarean section.

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The Effect of Gum Chewing, Early Oral Hydration, and Early Mobilization on Intestinal Motility After Cesarean Birth

Abstract: All of the three different interventions, such as gum chewing, early oral hydration, and early mobilization after cesarean birth, increase intestinal motility. The interventions are recommended during postoperative routine care to shorten hospital stay and prevent postoperative ileus.

Cited by 28 publications

References 44 publications

The Role of Gum Chewing in Regaining Bowel Motility in Patients Undergoing Cesarean Section: A randomized controlled trial

The Role of Gum Chewing in Regaining Bowel Motility in Patients Undergoing Cesarean Section: A randomized controlled trial

Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis

Chewing gum for intestinal function recovery after caesarean section: a systematic review and meta-analysis

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