Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial.
BACKGROUND
A preliminary report has been interpreted to suggest that gum chewing reduces duration of postcolectomy ileus.


METHODS
We rigorously tested this hypothesis in a prospective, randomized, placebo-controlled study. Patients undergoing open colectomy (n = 66) were randomized to receive 1 of 3 postoperative regimens beginning on postoperative day 1: sips (control, n = 21); sips and accupressure wrist bracelet (placebo, n = 23); and sips and gum chewing (treatment, n = 22). Patients were unaware of which regimen constituted placebo or treatment; end points were assessed by blinded investigators. Power was set a priori at 85% to detect a 0.75-day difference in time to first postoperative passage of flatus between placebo and treatment groups. Groups were compared using the log-rank test.


RESULTS
Groups were equivalent with respect to demographic and surgical characteristics. Median times to first postoperative passage of flatus were as follows: sips, 67 hours; bracelet and sips, 72 hours; gum and sips, 60 hours (p = 0.384). There were no significant differences in time to passage of first bowel movement, time until patients were ready for discharge, or time until actual discharge among the three groups. Inpatient and 30-day followup demonstrated no difference in frequency or distribution of postoperative complications.


CONCLUSIONS
In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.
Matros
Evan
E
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Rocha
Flavio
F
Zinner
Michael
M
Wang
John
J
Ashley
Stanley
S
Breen
Elizabeth
E
Soybel
David
D
Shoji
Brent
B
Burgess
Anne
A
Bleday
Ronald
R
Kuntz
Richard
R
Whang
Edward
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002638:Chewing Gum; D016009:Chi-Square Distribution; D003082:Colectomy; D005260:Female; D006801:Humans; D045823:Ileus / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
D002638:Chewing Gum; D010919:Placebos