J Korean Surg Soc.  2009 Nov;77(5):306-309. 10.4174/jkss.2009.77.5.306.

Can Gum Chewing Reduce Postoperative Ileus after Open Abdominal Surgery?

• Park SY
• Chung M

• KMID: 1750698
• DOI: http://doi.org/10.4174/jkss.2009.77.5.306

Abstract

PURPOSE
Gum chewing activates chephalic-vagal reflex as in food consumption and increases the release of gastrointestinal hormones which are related with gut motility. The objective of this study was to assess whether it is effective in shortening the time of hospitalization and postoperative ileus.
METHODS
Twenty patients who received open abdominal surgery for colon cancer in Gachon University, Gil Hospital were collected. They were further categorized to gum-chewing group (n=10, mean age=52.0 years, range 37 to 70) and control group (n=10, mean age=59.7 years, range 35 to 75) randomly. The patients in the gum-chewing group chewed gum three times a day from the first postoperative AM until the day they began oral intake. The time of gas out was recorded in each group.
RESULTS
The mean time of gas out were 2.35 days (SD 1.2) in gum-chewing group and 2.87 days (SD 1.2) in control group (P=0.41). The mean postoperative hospital days were 10.5 days in gum-chewing group and 13.0 days in control group (P=0.23).
CONCLUSION
There were no statistically significant results for shortnening of postoperative ileus and hospital day in this study.

Keyword

Gum-chewing; Postoperative ileus; Open abdominal surgery

MeSH Terms

Colonic Neoplasms
Gastrointestinal Hormones
Gingiva
Hospitalization
Humans
Ileus
Mastication
Reflex
Gastrointestinal Hormones

Reference

1. Asao T, Kuwano H, Nakamura J, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002. 195:30–32.

2. Livingston EH, Passaro EP Jr. Postoperative ileus. Dig Dis Sci. 1990. 35:121–132.

3. Stern RM, Crawford HE, Stewart WR, Vasey MW, Koch KL. Sham feeding. Cephalic-vagal influences on gastric myoelectric activity. Dig Dis Sci. 1989. 34:521–527.

4. Soffer EE, Adrian TE. Effect of meal composition and sham feeding on duodenojejunal motility in humans. Dig Dis Sci. 1992. 37:1009–1014.

5. Jepsen JM, Skoubo-Kristensen E, Elsborg L. Rectosigmoid motility response to sham feeding in irritable bowel syndrome. Evidence of a cephalic phase. Scand J Gastroenterol. 1989. 24:53–56.

6. Konturek SJ, Thor P. Relation between duodenal alkaline secretion and motility in fasted and sham-fed dogs. Am J Physiol. 1986. 251:G591–G596.

7. Schuster R, Grewal N, Greaney GC, Waxman K. Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg. 2006. 141:174–176.

8. Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorectal Dis. 2006. 8:64–70.

9. Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg. 1998. 187:46–54.

10. Bardon T, Ruckebusch Y. Comparative effects of opiate agonists on proximal and distal colonic motility in dogs. Eur J Pharmacol. 1985. 110:329–334.

11. Yukioka H, Bogod DG, Rosen M. Recovery of bowel motility after surgery. Detection of time of first flatus from carbon dioxide concentration and patient estimate after nalbuphine and placebo. Br J Anaesth. 1987. 59:581–584.