title: A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus.
abstract: BACKGROUND
  Recent trials have shown promising results for the efficacy of gum chewing for the amelioration of postoperative ileus. This finding could have a major clinical impact since gum chewing is relatively harmless and cheap while postoperative ileus has a significant impact on healthcare.
  
  
  METHODS
  Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of gum chewing after colorectal surgery to a standard control for the amelioration of postoperative ileus, expressed as time to flatus, time to defecation and overall hospital stay.
  
  
  RESULTS
  Five randomized controlled trials with a total number of 158 patients were found. The studies were homogeneous and a meta-analysis was performed. The pooled weighted mean difference (WMD) of time to flatus was significantly shorter for the gum-chewing group (20 h with a 95% confidence interval (CI) of 13-27). The pooled WMD of time to defecation was significantly shorter (29 h, 95% CI of 19-39). There was a non-significant trend towards a shorter postoperative hospital stay (1.3 days shorter, 95% CI of 3.2 days shorter to 0.6 days longer).
  
  
  CONCLUSIONS
  This meta-analysis shows a favorable effect of gum chewing on time to flatus and defecation but no significant effect on the hospital stay.
authors.affiliation: Academic Medical Center of the University of Amsterdam, Hilversum, The Netherlands.
authors.forename: S M M
authors.initials: SM
authors.lastname: de Castro
authors.forename: J W
authors.initials: JW
authors.lastname: van den Esschert
authors.forename: N T
authors.initials: NT
authors.lastname: van Heek
authors.forename: S
authors.initials: S
authors.lastname: Dalhuisen
authors.forename: M J W
authors.initials: MJ
authors.lastname: Koelemay
authors.forename: O R C
authors.initials: OR
authors.lastname: Busch
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
mesh_terms: D000328:Adult; D000368:Aged; D002638:Chewing Gum; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008409:Mastication; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
chemical_list: D002638:Chewing Gum