title: Nicotine gum chewing: a novel strategy to shorten duration of postoperative ileus via vagus nerve activation.
abstract: Postoperative ileus (POI) is a transit cessation of bowel motility after surgery. Substantial evidences suggest that gum chewing accelerate the recovery of bowel motility after surgery. Perioperative nicotine administration reduces postoperative opioid use and prevents postoperative nausea and vomiting. Nicotine gum chewing combines stimulation of the cephalic-vagal reflex by gum chewing, and activation of the cholinergic anti-inflammatory pathway by nicotine administration. We therefore hypothesized that nicotine gum chewing reduces POI and improves patient outcomes such as shortening the length of hospitalization as well as saving medical costs. As nicotine gum is commercially available, inexpensive, and has been in use for many years without any severe side effects, it may have a wide clinical application in POI prevention.
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: wuzhouqiao@gmail.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: G S A
authors.initials: GS
authors.lastname: Boersema
authors.affiliation: Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Jeekel
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Lange
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002638:Chewing Gum; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D045823:Ileus / Q000188:drug therapy*; D007902:Length of Stay; D009538:Nicotine / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D011950:Receptors, Cholinergic / Q000378:metabolism; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*
chemical_list: D000893:Anti-Inflammatory Agents; D002638:Chewing Gum; D011950:Receptors, Cholinergic; D009538:Nicotine