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Use of Chewing Gum in Reducing Postoperative Ileus After Elective Colorectal Resection: A Systematic Review

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Purpose

Published studies comparing the addition of chewing gum to standardized postoperative care to shorten postoperative ileus showed controversial results. This study was designed to conduct a systematic review of all relevant trials on chewing gum to reduce postoperative ileus after colorectal resection.

Methods

All published trials that compared the additional use of gum chewing with standard postoperative management were identified from Ovid MEDLINE, EMBASE, CINAHL, and All Evidence-Based Medicine Reviews between January 1991 and January 2007. The clinical outcomes were extracted and meta-analysis was performed by Forest plot review.

Results

Five randomized, controlled trials with 158 (94 males) patients with mean age of 61.9 years were included. Seventy-eight patients received an addition of gum chewing and 80 had standard postoperative care for colorectal resection. Operating time (P = 0.78) and blood loss (P = 0.48) were similar. All patients tolerated the gum without any side-effects. With combined standard postoperative care and gum chewing, the patients passed flatus 24.3 percent earlier (weighted mean difference, −20.8 hours; P = 0.0006) and had bowel movement 32.7 percent earlier (weighted mean difference, −33.3 hours; P = 0.0002). They were discharged 17.6 percent earlier than those having ordinary postoperative treatment (weighted mean difference, −2.4 days; P < 0.00001). The gum-chewing group was associated with similar overall postoperative complication rate (odds ratio, 0.45; P = 0.05) with individual complication showing a trend favoring gum chewing, although they were not of statistical significance. Readmission (odds ratio, 0.36; P = 0.24) and reoperation rates (odds ratio, 1.36; P = 0.83) of the two groups were similar.

Conclusions

The use of gum chewing in the postoperative period is a safe method to stimulate bowel motility and reduce ileus after colorectal surgery.

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Authors and Affiliations

  1. Department of Surgery, Caritas Medical Centre, 111, Wing Hong Street, Shum Shui Po, Kowloon, Hong Kong SAR, China

    Miranda K. Y. Chan M.B.B.S., F.R.A.C.S.

  2. Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Centre, Kowloon, Hong Kong SAR, China

    Wai Lun Law M.S., F.R.C.S.(Edinb.)

Authors
  1. Miranda K. Y. Chan M.B.B.S., F.R.A.C.S.
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  2. Wai Lun Law M.S., F.R.C.S.(Edinb.)
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Correspondence to Miranda K. Y. Chan M.B.B.S., F.R.A.C.S..

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Chan, M.K.Y., Law, W.L. Use of Chewing Gum in Reducing Postoperative Ileus After Elective Colorectal Resection: A Systematic Review. Dis Colon Rectum 50, 2149–2157 (2007). https://doi.org/10.1007/s10350-007-9039-9

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