The Effect of Chewing Gum on the Return of Bowel Activity after Colorectal Cancer Surgery.

BACKGROUND

Enhanced recovery after surgery (ERAS) protocols advocate for early enteral feeding to prevent postoperative ileus. Chewing gum acts as a type of sham feeding that triggers the cephalic phase of digestion by stimulating the cephalic vagus nerve. This can enhance gastrointestinal motility and may lead to quicker recovery of gas and bowel movements.

OBJECTIVES

To assess how chewing gum during the early postoperative phase affects the duration of postoperative ileus in terms of time to appreciation of first flatus, time to passage of first stools, and duration of hospital stay.

MATERIALS AND METHODS

The study was conducted in our division of colorectal surgery. This is a case-control study carried out over three years (2020-2023). A total of 100 patients were included, the first 50 were allocated to the control group, and another 50 were allocated to the chewing gum group. All patients above the age of 14 years who underwent resection for colorectal cancers were included.

RESULTS

The average age in the control group was 51.44 years and that in the chewing gum group was 50.04 years. The average duration of surgery for the control group was 156.3 minutes (2.6 hours) and 163.8 minutes (2.7 hours) in the chewing gum group. The average time of passage of the first flatus in the chewing gum group was 51.28 hours compared to 66.26 hours in the control group ( = 0.0002). The average time to first bowel movement in the chewing gum group was 71.42 hours. In comparison, the time to first bowel movement in the control group was 85.78 hours ( = 0.000011). The average hospital stay in the chewing gum group was 6.3 days and that in the control group was 6.4 days ( = 0.274254).

CONCLUSION

Chewing gum as a means of sham feeding is a cost-friendly method that significantly decreases the postoperative ileus but has no effect on postoperative hospital stay.

HOW TO CITE THIS ARTICLE

Zargar T, Wagay BA, Banday I, The Effect of Chewing Gum on the Return of Bowel Activity after Colorectal Cancer Surgery. Euroasian J Hepato-Gastroenterol 2024;14(2):210-213.