COMMENTARY

Is There a Benefit to Chewing Gum After Colorectal Surgery?

Albert B. Lowenfels, MD

Disclosures

September 13, 2016

Randomized Clinical Trial of Postoperative Chewing Gum Versus Standard Care After Colorectal Resection

Atkinson C, Penfold CM, Ness AR, et al
Br J Surg. 2016;103:962-970

Summary

To determine the potential benefit of gum chewing after colorectal resection, Atkinson and colleagues conducted a randomized trial in five UK hospitals. Hospital length of stay was the primary outcome measure for 402 patients undergoing colorectal surgery. Patients were randomly assigned to either 40 minutes of gum chewing or no gum chewing after surgery. Most of the patients in the gum-chewing group complied with the instructions to chew for at least 10 minutes, four times a day. Gum chewing did not shorten length of stay, appearance of bowel sound, or time to first passage of flatus.

Viewpoint

Several previous studies have detected a beneficial effect of chewing gum during postoperative bowel recovery. This large trial with good compliance found no benefit of gum chewing in regard to length of stay or any other measure of return of bowel function in patients who had undergone colorectal surgery. The findings agree with another recent large trial that failed to find any benefit of gum chewing after colorectal surgery.[1] One possible explanation for the absence of positive findings in the current study is that all of the participating hospitals used a fast-track approach, which included an early feeding program.

Chewing gum would have been a valuable and inexpensive aid to the gastrointestinal surgeon; unfortunately, the accumulating evidence questions its efficacy.

Abstract

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