Chewing Gum Eases Ileus after Colorectal Surgery

A new study suggests that chewing gum could serve as an effective method to ameliorate ileus following colorectal surgery.

Researchers at the Fourth Affiliated Hospital of China Medical University (Shenyang, China) searched PubMed, EMBASE, and Cochrane Library databases through February 2017 in order to identify randomized controlled trials (RCTs) that evaluated the efficacy of gum chewing in alleviating ileus following colorectal surgery. In all, the researchers identified 18 RCTs, involving 1,736 patients. Subgroup analyses were undertaken according to several criteria, including surgical approach; trials that adopted enhanced recovery after surgery (ERAS) protocol; and type of gum (sugared or not).

The results showed that chewing gum led to a shorter passage to first flatus, earlier recovery of bowel movement, and lower risk of postoperative ileus; ERAS and laparoscopic technique tended to cancel out chewing gum benefits. No significant advantages for adding chewing gum post-operatively were found for overall postoperative complications, nausea, vomiting, bloating, readmission, and reoperation. The study was published on August 31, 2017, in the International Journal of Surgery.

“Based on current evidence, chewing gum offers an inexpensive, well-tolerated, safe and effective method to ameliorate ileus following colorectal surgery,” concluded lead author Qing Liu, MD, of the department of general surgery, and colleagues. “Sorbitol-free or xylitol-free gum seemed to be less effective in ameliorating ileus following colorectal resection.”

Ileus is a disruption of the normal propulsive ability of the gastrointestinal (GI) tract. Current medical usage of the term restricts its meaning to those disruptions caused by the failure of peristalsis, rather than by mechanical obstruction. Partial temporary postsurgical ileus of the intestines occurs typically after abdominal surgery; since intestinal content is unable to move forward, food or drink should be avoided until peristaltic sound is heard by auscultation of the affected area. Chewing gum is a type of sham feeding that promotes intestinal motility via cephalic-vagal stimulation.

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