title: Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15% Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of hospitalisation periods. There is currently no guideline that supports the use of chewing gum after caesarean sections.
  
  
  OBJECTIVE
  To systematically analyse the published randomised controlled trials regarding the effectiveness of chewing gum in preventing POI in women undergoing caesarean sections.
  
  
  METHODS
  Systematic search of medical databases up to March 2013.
  
  
  METHODS
  Randomised controlled trials that reported the role of chewing gum in preventing POI in women undergoing caesarean sections.
  
  
  METHODS
  Two authors independently identified the relevant studies for inclusion, extracted outcome-related data, and analysed it systematically using REVMAN(®). The combined outcome was expressed as an odds ratio and standardised mean difference.
  
  
  RESULTS
  Seven randomised controlled trials involving 1462 women (728 in the chewing gum group, 734 controls) were systematically analysed. There was significant heterogeneity (χ(2) = 29.02, df = 7; P < 0.0001; I(2) = 76%) among the included trials. Among women undergoing caesarean sections, chewing gum reduced the risk of POI (odds ratio 0.36; 95% confidence interval 0.19-0.69; z = 3.08; P < 0.002) but did not affect duration of hospitalisation (P = 0.32).
  
  
  CONCLUSIONS
  Chewing gum for 30-60 minutes at least three times a day appears to be effective in reducing the incidence and consequences of POI following caesarean sections.
authors.affiliation: Department of Laparoscopic Colorectal Surgery, Worthing Hospital, Worthing, UK.
authors.forename: L
authors.initials: L
authors.lastname: Craciunas
authors.forename: M S
authors.initials: MS
authors.lastname: Sajid
authors.forename: A S
authors.initials: AS
authors.lastname: Ahmed
mesh_terms: D002585:Cesarean Section; D002638:Chewing Gum; D005260:Female; D006801:Humans; D045823:Ileus / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D002638:Chewing Gum
keywords: Caesarean section; chewing gum; postoperative ileus