title: Gum chewing stimulates early return of bowel motility after caesarean section.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of postoperative gum chewing on the recovery of bowel motility after caesarean section.
  
  
  METHODS
  A randomised controlled study.
  
  
  METHODS
  Faculty of Medicine, Ain Shams University, Egypt.
  
  
  METHODS
  A total of 200 pregnant women delivered by elective caesarean section (CS) under general anaesthesia.
  
  
  METHODS
  Women were randomised into two groups; group A (93 women) who received one stick of sugarless gum for 15 minutes every 2 hours after surgery, and group B (107 women) had traditional management (oral intake of clear fluids allowed after passage of flatus and regular diet with the passage of bowel movement).
  
  
  METHODS
  Time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement and length of hospital stay.
  
  
  RESULTS
  The mean duration of surgery was longer in group A (41.3 +/- 7.5 versus 38.4 +/- 8.1 minutes, P < 0.05). The mean postoperative time interval to first hearing of normal intestinal sounds (10.9 +/- 2.7 versus 15.6 +/- 3.7 hours), passage of flatus (17.9 +/- 4.6 versus 24.4 +/- 7.1 hours), defecation (21.1 +/- 4.7 versus 30 +/- 8.2 hours) and discharge from the hospital (40.8 +/- 10.6 versus 50.5 +/- 8.9 hours) were significantly shorter in group A (P < 0.001). Severe ileus occurred only in one woman belonging to group B. All patients in group A tolerated gum chewing beginning on the first postoperative day.
  
  
  CONCLUSIONS
  Gum chewing after CS is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stay; with potential impact on reducing the overall healthcare costs in case of routine implementation.
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt. kabdelmaeboud@yahoo.com
authors.forename: K H I
authors.initials: KH
authors.lastname: Abd-El-Maeboud
authors.forename: M I
authors.initials: MI
authors.lastname: Ibrahim
authors.forename: D A A
authors.initials: DA
authors.lastname: Shalaby
authors.forename: M F
authors.initials: MF
authors.lastname: Fikry
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002638:Chewing Gum; D003672:Defecation / Q000502:physiology; D005260:Female; D005740:Gases; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007902:Length of Stay; D011182:Postoperative Care / Q000379:methods*; D011247:Pregnancy; D013997:Time Factors
chemical_list: D002638:Chewing Gum; D005740:Gases