title: Sham feeding with chewing gum after elective colorectal resectional surgery: a randomized clinical trial.
abstract: OBJECTIVE
  To determine whether sham feeding with chewing gum improved gastrointestinal recovery after colorectal resection surgery, in the presence of routine postoperative feeding.
  
  
  BACKGROUND
  Sham feeding with chewing gum has been shown to accelerate the return of gut function after colorectal surgery. This study sought to determine whether sham feeding with gum, after colorectal resection, accelerates return of gastrointestinal function in patients on a rapid feeding enhanced recovery program.
  
  
  METHODS
  A randomized "two armed" controlled clinical trial was performed. Equal groups of open and laparoscopic colorectal resection surgical patients were recruited. Patients in the intervention arm received chewing gum 4 times a day postoperatively. All patients in the trial were placed on an established, standardized Enhanced Recovery After Surgery program. The primary outcome was time to return of gut function, assessed by time to flatus and first bowel motion. Secondary outcomes were time to tolerate diet, symptoms of ileus in the form of nausea, vomiting and distension, pain as assessed by analgesic consumption and visual analogue scales, complications, and length of hospital stay.
  
  
  RESULTS
  A total of 161 patients were recruited. Postoperative morbidity was equivalent between groups, with no complications related to gum chewing. There was no difference between groups with respect to the primary outcomes of time to flatus and bowel motion. There was less perception of pain in the intervention group on days 2 to 5, and no difference with respect to all other secondary outcomes.
  
  
  CONCLUSIONS
  Sham feeding with gum, after open and laparoscopic colorectal resectional surgery is safe, but does not hasten the return of gastrointestinal function in patients who receive accelerated postoperative feeding. (ACTRN12607000538448).
authors.affiliation: John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lim
authors.forename: Owen James
authors.initials: OJ
authors.lastname: Morris
authors.forename: Gregory
authors.initials: G
authors.lastname: Nolan
authors.forename: Sarah
authors.initials: S
authors.lastname: Moore
authors.forename: Brian
authors.initials: B
authors.lastname: Draganic
authors.forename: Stephen Ridley
authors.initials: SR
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002638:Chewing Gum; D003107:Colorectal Surgery; D017558:Elective Surgical Procedures; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010147:Pain Measurement; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting; D020127:Recovery of Function
chemical_list: D002638:Chewing Gum