Chewing Gum Gains Support for Speeding Recovery from Colon Surgery

According a review published in the Archives of Surgery, evidence supports that recovery time following colon surgery is significantly faster when patients are given chewing gum. One of the first measures of successful outcomes after colon surgery is passing flatus, and having a bowel movement.

A common complication of colon surgery is paralytic ileus, a common result of bowel surgery where the bowel becomes immobilized, and gas and food cannot pass normally because peristalsis is absent or greatly diminished. Treatment requires expensive drugs, increased need for pain control, and invasive tubes to relieve pressure in the abdomen, involving increased cost, and additional stress to patients.

The authors of the current review analyzed data from past studies regarding the benefits of giving chewing gum following colon surgery to qualify their conclusions, researching databases from MEDLINE, Embase, Ovid, and Cochrane.

Studies included were required to “(1) compare abdominal surgery with and without the use of chewing gum postoperatively; (2) report on at least 1 of the outcomes of interest (return to enteric function and length of postoperative stay); (3) clearly document whether or not chewing gum was used; and (4) clearly report the reasons for surgery.” (Arch Surg. 2008;143(8):788-793). The research group excluded studies where the outcomes or techniques were not clear, if there was an overlap of authors or study participants, or if data could not be properly extracted.

Patients were given sugarless gum to chew, three times a day for 5 to 45 minutes. In all of the studies, circumstances surrounding each surgery were identical, with the exception of two, where sips of water before bowel function returned. Five trials were ultimately used, involving 158 patients. Of interest, sugarless chewing gums contain sorbitol, a known laxative, but much less expensive when supplied via a stick of chewing gum versus a suspension or suppository from the hospital pharmacy.

The authors conclude that their investigation warrants larger studies, especially in terms of healthcare spending. They write that, “The potential benefits to individual patients, in health economics terms, are such that a well-designed, large-scale, blinded, randomized, controlled trial with a placebo arm is warranted to answer the question of whether gum chewing can significantly reduce the length of stay after abdominal surgery or whether it merely represents a placebo effect. With increasing pressure on limited health care resources and continually needing to improve the quality of patients' perioperative experience, interventions with the potential to limit the discomfort of postoperative ileus and reduce the length of postoperative stay are welcomed.”

Source: Arch Surg. 2008;143(8):788-793.