Cochrane: A common consequence of abdominal surgery is that the patient’s
digestive system stops working for a few days. This is called ileus and
it can be both painful and uncomfortable for the patient. Ileus can
lead to nausea, vomiting, and abdominal discomfort and is associated
with complications, reduced patient satisfaction, and increased length
of hospital stay.
Chewing gum is hypothesized to reduce
postoperative ileus by stimulating early recovery of gastrointestinal
function. Chewing gum tricks the body into thinking it is eating,
causing the digestive system to start working again. Given that most
people have previous experience of chewing gum, the intervention is
generally well tolerated by individuals. Chewing gum as an intervention
is also low-cost and easy to implement.
A team of Cochrane authors, based in the UK and Denmark and working with the Cochrane Colorectal Cancer Group,
set out to evaluate if chewing gum after surgery hastens the return of
gastrointestinal function. Randomized controlled trials that used
chewing gum as an intervention compared to a control group were
included. In the review there were 81 studies that recruited 9072
participants. The studies mainly focussed on people having bowel surgery
or caesarean section, but there were some studies of other surgery
types. Many of the studies were rated at high or unclear risk of bias.
There
was some evidence that people who chewed gum after an operation were
able to pass wind and have bowel movements sooner than people who did
not chew gum. There was also some evidence that people who chewed gum
had bowel sounds (gurgling sounds heard using a stethoscope) slightly
sooner. In some studies, those chewing gum reported reduced nausea and
vomiting and other complications. There was a small difference in how
long people stayed in hospital between people who did or did not chew
gum. There was little difference in mortality, infection risk and
readmission rate between the groups.
“Chewing gum is an innovative
and low cost intervention. This review identified some evidence that
chewing gum after surgery may help the patient’s digestive system to
recover faster,” said Vaneesha Short, a researcher at the NIHR
Biomedical Research Unit in Nutrition, Diet and Lifestyle in Bristol,
and the lead author of the Cochrane Review. “We know that there are many
factors that affect the onset of ileus. More high quality studies are
needed to explore the effects of chewing gum after a variety of
different types of surgery.”