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Colorectal Dis. 2018 May;20(5):438-448. doi: 10.1111/codi.13930.

Gum chewing aids bowel function return and analgesic requirements after bowel surgery: a randomized controlled trial.

Byrne CM1,2, Zahid A1,2,3, Young JM2,3, Solomon MJ1,2,3, Young CJ1,2.

Author information

1
Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
2
School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
3
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Abstract

AIM:

The aim was to compare the effectiveness of chewing sugar-free gum after bowel resection on bowel function and length of stay.

METHOD:

This was a randomized controlled trial of patients undergoing elective open or laparoscopic bowel surgery, who were allocated into two groups: a chewing gum group (CG); or a nonchewing gum group (NG). Primary outcomes were time to discharge (length of hospital stay [LOS]), time to first flatus (TFF) and time to first bowel motion (TBM). Secondary outcomes were complication rates, pain and total morphine equivalent (TMEq) medication for 7 days after the procedure.

RESULTS:

Between 2010 and 2013, 162 patients were randomized; four were excluded, leaving 158 in the study (82 in the CG and 76 in the NG). There was no difference in LOS between the CG (5.8 days) and the NG (6.1 days) (P = 0.403) or in the median TFF between the CG (42.0 h) and the NG (58.0 h) (P = 0.076). The median TBM was lower in the CG (40.0 h) than in the NG (90.0 h) (P = 0.002). There was no difference in intra-operative complications between the CG (9%) and the NG (9%) (P = 0.901) or in early postoperative complications (44% for CG and 55% for NG) (P = 0.131). There was no difference in TMEq at 24 h postprocedure, but the CG had reduced TMEq from days 2 to 7 post procedure and for the 7-day total. Pain was higher among patients in the NG on day 3.

CONCLUSION:

Chewing sugar-free gum resulted in an earlier return to bowel function and decreased analgesic requirements. There was no decrease in overall LOS or postoperative complications.

KEYWORDS:

Chewing gum; bowel function; surgery

PMID:
29053219
DOI:
10.1111/codi.13930
[Indexed for MEDLINE]

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