title: Postoperative gum chewing after gynecologic laparoscopic surgery: a randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynecologic surgery.
  
  
  METHODS
  In this randomized controlled trial, patients were allocated to either postoperative gum chewing every 2 hours for 15 minutes or standard postoperative care without gum chewing. The study's primary end points were time to first regular bowel sounds and time to first passage of flatus after surgery. Secondary end points were time of operation to first defecation, patient satisfaction concerning postoperative gum chewing, potential side effects of postoperative gum chewing, and potential effect of gum chewing on postoperative pain therapy.
  
  
  RESULTS
  One hundred seventy-nine patients were included in this trial. We found a significantly shorter interval between surgery and passage of first flatus in the intervention group compared with the control group (median 6.2 hours compared with 8.1 hours; P=.002) and a significantly higher rate of regular bowel sounds 3 hours (76% compared with 47%; P<.001) and 5 hours (91% compared with 78%; P=.01) after surgery. Fewer opioid analgetics were administered to patients allocated to the intervention group (P=.02). There was no significant difference in time to first defecation between groups (median 26.3 hours compared with 29.0 hours, P=.165). Gum chewing was well tolerated and well accepted by patients, and no intervention-related side effects were observed.
  
  
  CONCLUSIONS
  Gum chewing seems to have beneficial effects on bowel motility when used as an adjunct treatment in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynecologic laparoscopic surgery.
  
  
  BACKGROUND
  www.ClinicalTrials.gov, NCT 01549353.
  
  
  METHODS
  I.
authors.affiliation: Departments of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Klagenfurt, and Medical University Vienna, Wien, Austria.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Husslein
authors.forename: Maximilian
authors.initials: M
authors.lastname: Franz
authors.forename: Martina
authors.initials: M
authors.lastname: Gutschi
authors.forename: Christof
authors.initials: C
authors.lastname: Worda
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.forename: Heinz
authors.initials: H
authors.lastname: Leipold
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002638:Chewing Gum; D003672:Defecation; D005260:Female; D005769:Gastrointestinal Motility; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011182:Postoperative Care; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002638:Chewing Gum