Does Gum Chewing Reduce Postoperative Ileus after Intestinal Resection in Children? A Prospective Randomized Controlled Trial

Abstract

Introduction: The aim of this study was to determine whether the addition of gum chewing to standardized postoperative care is associated with a significantly earlier return of bowel function compared to simple postoperative management in children with intestinal anastomosis.

Materials and Methods: We performed a prospective, randomized, controlled trial. All patients who underwent laparotomy with either colon or small bowel resection between June 2006 and March 2008 were randomized to one of two groups. Group one consisted of patients receiving standardized postoperative care plus gum chewing (gum-chewing group) (n=15); Group two consisted of patients receiving only standardized postoperative care (control group) (n=15). The patients in the gum-chewing group chewed one stick of sugarless gum three times per day, for an hour, each day.

Results: The groups were statistically similar. The time to first flatus was 35.73±14.67 h in the gum-chewing group and 42.00±20.77 h in the control group (p=0.347). The time to first bowel movement was 56.27±22.14 h in the gum-chewing group and 63.00±26.34 in the control group (p=0.444). The length of hospital stay was 5.80±0.68 days for the gum-chewing group and 6.67±0.98 days for the control group (p=0.005). The hospital charges were 2451±806 YTL for the gum-chewing group and 2102±678 YTL for the control group (p=0.206).

Conclusions: The addition of gum chewing to the standardized postoperative care of children with intestinal anastomosis was not associated with a significantly earlier return of bowel function compared to simple postoperative management, but it was associated with an earlier discharge from hospital, although this earlier discharge had only minor clinical significance and no difference was found in hospital charges.

Key words

chewing gum - postoperative care - anastomosis - laparotomy - child

References

• 1 Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review.  Dis Colon Rectum. 2007;  50 2149-2157
• 2 Kellow JE, Delvaux M, Azpiroz F, Camilleri M, Quigley EM, Thompson DG. Principles of applied neurogastroenterology: physiology/motility-sensation.  Gut. 1999;  45 ((Suppl 2)) 17-24
• 3 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
• 4 Schuster R, Grewal N, Greaney GC, Waxman K. Gum chewing reduces ileus after elective open sigmoid colectomy.  Arch Surg. 2006;  141 174-176
• 5 Zhang Q, Zhao P. Influence of gum chewing on return of gastrointestinal function after gastric abdominal surgery in children.  Eur J Pediatr Surg. 2008;  18 44-46

Correspondence