title: The efficacy of gum chewing in reducing postoperative ileus: a multisite randomized controlled trial.
abstract: OBJECTIVE
  The purpose of this prospective, attention-controlled, randomized study was to determine whether postoperative gum chewing reduces the duration of postoperative ileus symptoms following elective open or laparoscopic sigmoid colectomy when compared with standard care or an attention-control intervention.
  
  
  METHODS
  Forty-seven subjects scheduled for either an open or laparoscopic colon resection participated in the study. Subjects were recruited preoperatively at the preadmission learning centers of the 2 acute care medical centers that comprised the study settings.
  
  
  METHODS
  Subjects were randomized to 3 groups: (1) standard postoperative care (n = 18); (2) standard care and a silicone-adhesive patch applied to the deltoid region of the upper arm as an attention control (n = 16); and (3) standard care and gum chewing (n = 13). Standard postoperative care included removal of the nasogastric tube, early ambulation, nothing by mouth with ice chips only until the first passage of flatus, and then advancement of diet until tolerance of solid food.
  
  
  RESULTS
  No statistically significant differences were found among the 3 study groups for the 4 postoperative outcome variables measured: (1) first passage of flatus; (2) first bowel movement; (3) return of hunger; and (4) ability to tolerate solid food for one meal.
  
  
  CONCLUSIONS
  Postoperative gum chewing was not found to be more effective than standard postoperative care or our attention-control intervention in reducing the duration of postoperative ileus symptoms, length of stay, or complications among patients following open/laparoscopic sigmoid colectomy.
authors.affiliation: David Anthony (Tony) Forrester, PhD, RN, ANEF, Professor and Senior Associate Dean, Academic Affairs and Administration, Rutgers School of Nursing (formerly University of Medicine and Dentistry of New Jersey-School of Nursing) and, at the time of this study, he was Professor in Residence-Interdisciplinary Health Research Consultant, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey. Janet Doyle-Munoz, BSN, RN, CWON, Wound and Ostomy Nurse, Morristown Medical Center-Atlantic Health System, Morristown, New Jersey. Toni McTigue, APRN, BC, CWOCN, Wound, Ostomy and Continence Nurse, Morristown Medical Center-Atlantic Health System, Morristown, New Jersey. Stephanie D'Andrea, BS, RN, CWON, Wound and Ostomy Nurse, Overlook Medical Center-Atlantic Health System, Morristown, New Jersey. Angela Natale-Ryan, BS, RN, CWON, Wound and Ostomy Nurse, Overlook Medical Center-Atlantic Health System, Morristown, New Jersey.
authors.forename: David Anthony Tony
authors.initials: DA
authors.lastname: Forrester
authors.forename: Janet
authors.initials: J
authors.lastname: Doyle-Munoz
authors.forename: Toni
authors.initials: T
authors.lastname: McTigue
authors.forename: Stephanie
authors.initials: S
authors.lastname: D'Andrea
authors.forename: Angela
authors.initials: A
authors.lastname: Natale-Ryan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002638:Chewing Gum; D003082:Colectomy; D012809:Colon, Sigmoid / Q000601:surgery; D005260:Female; D006801:Humans; D045823:Ileus / Q000517:prevention & control*; D008297:Male; D008409:Mastication; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies
chemical_list: D002638:Chewing Gum