Gum Chewing Reduces Ileus After Elective Open Sigmoid Colectomy

Abstract

HYPOTHESIS: Gum chewing after elective open colon resection may stimulate bowel motility and decrease duration of postoperative ileus. DESIGN AND SETTING: Prospective, randomized study in a community-based teaching hospital. PATIENTS: Thirty-four patients undergoing elective open sigmoid resections for recurrent diverticulitis or cancer. MAIN OUTCOME MEASURES: First feelings of hunger, time to first flatus, time to first bowel movement, length of hospital stay, and complications. RESULTS: A total of 34 patients were randomized into 2 groups: a gum-chewing group (n = 17) or a control group (n = 17). The patients in the gum-chewing group chewed sugarless gum 3 times daily for 1 hour each time until discharge. Patient demographics, intraoperative, and postoperative care were equivalent between the 2 groups. All gum-chewing patients tolerated the gum. The first passage of flatus occurred on postoperative hour 65.4 in the gum-chewing group and on hour 80.2 in the control group (P = .05). The first bowel movement occurred on postoperative hour 63.2 in the gum-chewing group and on hour 89.4 in the control group (P = .04). The first feelings of hunger were felt on postoperative hour 63.5 in the gum-chewing group and on hour 72.8 in the control group (P = .27). There were no major complications in either group. The total length of hospital stay was shorter in the gum-chewing group (day 4.3) than in the control group (day 6.8), (P = .01). CONCLUSIONS: Gum chewing speeds recovery after elective open sigmoid resection by stimulating bowel motility. Gum chewing is an inexpensive and helpful adjunct to postoperative care after colectomy.