Gum-chewing may speed recovery after colon surgery

A small study suggests that chewing gum after colon surgery may speed the return of normal bowel function and shorten patients' hospital stays, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals.

Any type of abdominal surgery can cause ileus, a marked decrease or stoppage of intestinal function, according to background information in the article. Pain, vomiting and abdominal distension are the immediate consequences. Ileus also can lead to longer hospital stays, an increased risk of infection and problems breathing, the authors report.

Rob Schuster, M.D., and colleagues at Santa Barbara Cottage Hospital, California, studied 34 patients who underwent sigmoid colon resection, in which surgeons remove a portion of the large intestine, for cancer or recurrent diverticular diseases. Seventeen of the patients chewed sugarless gum three times a day beginning the morning after their surgeries and lasting until their first bowel movement. The other 17 patients, who did not differ in age, gender, reason for surgery or number of previous surgeries, served as controls.

The gum-chewing group left the hospital after an average of 4.3 days, compared with 6.8 days for the control group. Patients who chewed gum also passed gas sooner (65.4 hours vs. 80.2 hours post-surgery) and had their first bowel movement earlier (after 63.2 hours compared with 89.4 hours) than those who did not. There were no major complications in either group and the gum-chewers had no problems tolerating the gum. All of them continued to chew gum until their bowels began to function again.

Chewing gum may stimulate the same nerves in the body as eating, promoting the release of hormones that activate the gastrointestinal tract, the researchers write. "Early postoperative feeding may stimulate bowel motility, however, many patients fed early after colectomies do not tolerate this," they write. "In a study where patients were given water four hours postoperatively, 20 percent of these patients did not tolerate the intervention."

Gum-chewing may serve as a feasible alternative, an "inexpensive and helpful adjunct to postoperative care after colectomy," they conclude.

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(Arch Surg. 2006;141:174-176. Available pre-embargo to the media at www.jamamedia.org.)


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