COMMENTARY

More Data on Chewing Gum After Bowel Surgery

Albert B. Lowenfels, MD

Disclosures

November 17, 2016

Randomized Clinical Trial of Chewing Gum After Laparoscopic Colorectal Resection

Shum NF, Choi HK, Mak JC, et al
Br J Surg. 2016;103:1447-1452

Summary

Does gum chewing hasten the return of bowel function after colorectal surgery? Shum and colleagues performed a trial in 82 patients randomly assigned to a standardized recovery program after laparoscopic surgery, which included or excluded chewing gum three times daily as part of the regimen. Patients underwent either a colonic resection (n = 45) or a rectal resection (n = 37). For patients in the gum-chewing group, there was a significant decrease in length of time until passage of flatus (18 vs 34 hours) and a corresponding reduction in time to first bowel movement (respective P values: .007 and .001). Gum chewing seemed to have a more pronounced effect in patients undergoing surgery for colon cancer compared with rectal cancer.

Viewpoint

The results of this study agree with some, but not all, prior reports on the potential benefit of gum chewing on the return of bowel function after bowel surgery.[1] A summary of six randomized studies examining this issue did find that chewing gum reduced the length of hospital stay following bowel surgery.[2] Is there a biological explanation for why gum chewing should be beneficial? Perhaps it simulates oral food intake and acts to encourage return of bowel function via vagal nerve stimulation. Even without a clear explanation, if a simple, safe, inexpensive activity can enhance recovery following major abdominal surgery, then it may be a worthwhile recommendation for our patients. "Bring along a pack of chewing gum" could be included in our list of preoperative instructions to patients requiring bowel surgery.

Abstract

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