The effect of Gum chewing on postoperative ileus after cesarean section
Abstract Number: 148
Abstract Type: Original Research
Introduction: Postoperative ileus is common after cesarean section and can delayed recovery and prolong hospital stay. Gum chewing, a type of sham feeding, may to stimulate gut motility via cephalic-vagal stimulation, and may accelerate return of bowel function and reduce morbidity and length of hospital stay. (1,2) This study aimed to determine whether gum chewing in the immediate postoperative period facilitated recovery from ileus following cesarean section.
Methods: During prospective randomized controlled trial five hundred pregnant women who underwent cesarean delivery were randomly divided into two groups: 1- gum-chewing group (N = 238), 2- control group (N = 262). Demographic data, duration of surgery, type of anesthesia, and time of discharge from hospital were recorded. Patients in the gum-chewing group chewed gum three times per day at least half an hour each time as soon as after surgery until the regular diet was initiated. Patient demographics, intra-operative, and postoperative care were the same for both group .The T test and Pearson chi-square test was used for statistical analysis.
Results: Chewing gum was well tolerated by all the patients immediately after cesarean section. Bowel sounds were heard earlier in the gum-chewing group (mean 13.6 hours) than in the control group (mean 18.4 hours). Median times to first postoperative passage of flatus (15.7 versus 21.4 hours), first bowel movement (19.8 versus 27.3 hours) were significantly shorter in gum-chewing group (P < 0.001). 2% of Patients in gum-chewing group had mild ileus in compare to 10% in control group. There was virtually no difference in either time-to hospital discharge between two groups.
Conclusion: The use of gum chewing in the postoperative period is a safe, inexpensive and convenient method in enhancing the recovery of bowel function and reduces ileus after cesarean section.
1. Shang H, Yang Y, Tong X, Zhang L, Fang A, Hong L. Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol. 2010 May;27(5):387-91.
2. Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009 Sep;116(10):1334-9.