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

Abstract

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.

Study of different types of gum in induction of earlier gastrointestinal recovery after elective cesarean section: A randomized controlled trial

“…The findings of Shabaan & Dieb [9] support ours, showing a statistically significant difference between the two groups in the auscultation of the initial intestinal sounds, the passage of flatus, and the transit of stools (P value 0.001,0.001,0.001, respectively).…”

“…There was a statistically significant difference in the initial normal intestinal sounds between the two groups, as shown by Shabaan & Dieb [9].…”

“…Another study [9] by Shabaan & Dieb looked at the function of gum chewing in helping caesarean section patients restore their intestinal motility, and found that the two groups were statistically equivalent in terms of demographics.…”

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

“…The implementation of ERAS protocol has been proven to lower the economic burden of hospitalization associated with prolonged POI [35]. As a part of ERAS protocol, sham feeding through chewing gum has been studied in multiple RCTs to prevent the prolonged POI [19], [20], [21], [36], [37]. These trials were initiated by a research group led by Asao in 2002 [38], who was motivated by early post-operative oral feeding [10], [11].…”

“…studies have reported the accelerated intestinal function recovery for patients treated with chewing gum after gynecological surgery [19], [20], [21]. Furthermore, chewing gum may reduce the level of post-operative pain and analgesic requirement [22], [23], [24], [25].…”