title: Role of gum chewing on the duration of postoperative ileus following ileostomy closure done for typhoid ileal perforation: a prospective randomized trial.
abstract: OBJECTIVE
  There is ample evidence in the recent literature that gum chewing after elective colonic anastomosis decreases postoperative ileus (POI). But there are very few studies on small bowel anastomosis done in relaparotomy cases. This study aimed to evaluate the effect of gum chewing on the duration of POI following small bowel anastomosis performed for the closure of intestinal stoma, made as temporary diversion in the selected cases of typhoid perforation peritonitis.
  
  
  METHODS
  Hundred patients undergoing elective small bowel anastomosis for the closure of stoma were randomly assigned to the study group (n=50) and the control group (n=50). The study group patients chewed gum thrice a day for 1 h each time starting 6 h after the surgery until the passage of first flatus. The control group patients had standard postoperative treatment.
  
  
  RESULTS
  Study and control group patients were comparable at inclusion. The mean time for the appearance of bowel sounds as well as the passage of first flatus was significantly shorter in the study group (P=0.040, P=0.006). The feeling of hunger was also experienced earlier in study group cases (P=0.004). The postoperative hospital stay was shorter in the study group, but the difference was not significant (P=0.059).
  
  
  CONCLUSIONS
  The cases of relaparotomy requiring additional adhesiolysis and small bowel anastomosis for stoma closure are benefited by postoperative gum chewing.
authors.affiliation: Department of Surgery, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India. drsanjay.marwah@gmail.com
authors.forename: Sanjay
authors.initials: S
authors.lastname: Marwah
authors.forename: Sham
authors.initials: S
authors.lastname: Singla
authors.forename: Pradeep
authors.initials: P
authors.lastname: Tinna
mesh_terms: D002638:Chewing Gum; D006184:Habits; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery*; D007081:Ileostomy; D045823:Ileus / Q000453:epidemiology*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors; D014435:Typhoid Fever / Q000150:complications*
chemical_list: D002638:Chewing Gum