title: Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial.
abstract: 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.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Matros
authors.forename: Flavio
authors.initials: F
authors.lastname: Rocha
authors.forename: Michael
authors.initials: M
authors.lastname: Zinner
authors.forename: John
authors.initials: J
authors.lastname: Wang
authors.forename: Stanley
authors.initials: S
authors.lastname: Ashley
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Breen
authors.forename: David
authors.initials: D
authors.lastname: Soybel
authors.forename: Brent
authors.initials: B
authors.lastname: Shoji
authors.forename: Anne
authors.initials: A
authors.lastname: Burgess
authors.forename: Ronald
authors.initials: R
authors.lastname: Bleday
authors.forename: Richard
authors.initials: R
authors.lastname: Kuntz
authors.forename: Edward
authors.initials: E
authors.lastname: Whang
mesh_terms: 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
chemical_list: D002638:Chewing Gum; D010919:Placebos