Gum Chewing Improves Bowel Motility After Laparoscopic Surgery

July 22, 2013

After minimally invasive laparoscopic surgery, gum chewing has beneficial effects on bowel motility when used as an adjunct treatment in postoperative care, according to the results of a randomized controlled trial.

After minimally invasive laparoscopic surgery, gum chewing has beneficial effects on bowel motility when used as an adjunct treatment in postoperative care, according to the results of a randomized controlled trial.1
   
This new finding adds value to the results of previous studies, one of which showed that gum chewing is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stays after cesarean deliveries.2 The idea behind gum chewing is that the process of chewing triggers the digestive system to prepare for receiving food.
   
In this study of 179 women who underwent laparoscopic surgery for a benign gynecological condition, patients were randomized to either postoperative gum chewing or standard postoperative care without gum chewing.1 Patients in the gum-chewing group were asked to chew gum for 15 minutes every 2 hours postoperatively. The time to first regular bowel sounds and the time to first passage of flatus after surgery were recorded for all patients.
   
Compared with the control group, patients in the gum-chewing group had a significantly shorter interval between surgery and the passage of their first flatus, reported the study authors. The average time time to first flatus in the intervention group was 6.2 hours, compared with 8.1 hours in the control group (P=0.002). In addition, patients in the gum-chewing group had a faster return of regular bowel sounds postsurgery. At 3 hours postsurgery, 76% of patients in the intervention group had a return of regular bowel sounds, compared with 47% of patients in the control group (P<0.001). At 5 hours postsurgery, regular bowel sounds were heard in 91% of patients in the intervention group and in 78% of patients in the control group (P=0.02).
   
Another benefit of gum chewing seems to be a reduced need for analgesics after surgery. Significantly fewer patients in the intervention group than in the control group were administered analgesics postoperatively (P=0.02). Although patients in the intervention group had a shorter average time to first defecation than patients in the control group, the difference between groups was not significant (26.3 hours vs 29 hours, respectively; P=0.165).
   
Overall, gum chewing was well tolerated and accepted by patients. The study authors recorded no intervention-related adverse effects, although gum inhalation could occur theoretically in a drowsy postoperative patient. Gum chewing is a safe and cost-effective means to improve bowel motility after gynecological laparoscopic surgery and should be recommended to all patients, concluded the study authors.

Pertinent Points:
- Gum chewing after laparoscopic gynecological surgery reduces the time to first flatus and is associated with a faster return of regular bowel sounds.
- Use of gum chewing as an adjunct treatment to standard postoperative care is well tolerated and well accepted by patients.
 

References:

1. Hussiein H, Franz M, Gutschi M, et al. Postoperative gum chewing after gynecologic laparoscopic surgery: a randomized controlled trial. Obstet Gynecol. 2013;122:85-90.
2. Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009;116:1334-1339.