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Gum Chewing Eases Postoperative Ileus, Speeds Hospital Discharge: Presented at ACS

By Crystal Phend

SAN FRANCISCO, CA -- October 25, 2005 -- A pack of gum could help patients go home a day early and ease painful loss of bowel function after elective laparoscopic colectomy, researchers said here at the American College of Surgeons (ACS) annual meeting.

Postoperative ileus can cause pain, abdominal distention, constipation, vomiting and dehydration, said Harry Papaconstantinou, MD, Assistant Professor, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States, in a presentation on October 17^th.

The most common cause of prolonged hospitalization after colon surgery, postoperative ileus is considered inevitable after colon resection and other intestinal surgeries. Patients typically cannot tolerate full meals but lack of feeding hinders return of normal bowel function. Chewing without swallowing is thought to be an effective intermediate measure, Dr. Papaconstantinou said.

Previously, researchers have demonstrated that His sham feeding was associated with accelerated return of bowel function. Dr. Papaconstantinou and colleagues therefore undertook a randomized, prospective study to determine the effect of gum chewing on postoperative bowel function and hospital stay.

The researchers enrolled 88 patients who were scheduled to undergo open or laparoscopic colectomy. Patients were randomized to receive either sips of clear liquids or one stick of gum for 15 minutes 4 times a day after surgery.

Patients had a mean age of 60 years; 37 patients had open colectomy and 51 had laparoscopic resection. Anesthesia time, a possible ileus stimulus, was similar in the two groups.

Laparoscopic colectomy patients in the gum chewing group had a significantly earlier return of bowel function; the first defecation in the gum group was at 2.6 days compared to 3.3 days for the clear liquids group.

Length of hospital stay was significantly improved in the gum chewing laparoscopic surgery group (4.0 days versus 5.3 days).

Among patients undergoing open colectomy, there was virtually no difference in either time-to hospital discharge, with 5.6 days in the gum group versus 5.3 days in the clear liquids group. There was also no different in time to first defecation between the gum and clear liquids group, with 3.6 days versus 3.9 days, respectively.

"Prescribing chewing-gum in the postoperative period may be an inexpensive intervention to facilitate recovery and decrease hospital cost," the authors concluded.


[Presentation title: The Effects of Gum-Chewing on Bowel Function and Hospital Stay After Laparoscopic vs Open Colectomy: A Multi-Institution Prospective Randomized Trial. Forum on Surgical Problems -- Quality, Outcomes, and Cost I. Abstract SF05-OC1]

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