title: A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery.
abstract: OBJECTIVE
  To assess whether chewing gum prevents postoperative ileus after laparotomy for benign gynecologic surgery.
  
  
  METHODS
  A randomized study was conducted from December 1, 2010, to February 29, 2012. Patients scheduled to undergo laparotomy were randomly assigned to receive chewing gum or routine care after surgery. A chart review was performed to establish incidence of nausea and vomiting, use of antiemetics, cases of postoperative ileus (≥2 episodes of emesis of 100 mL or more, with abdominal distention and absence of bowel sounds), and time to discharge. Inpatient surveys recorded the time to specific events.
  
  
  RESULTS
  A total of 109 patients were randomly assigned to receive chewing gum (n=51) or routine postoperative care (n=58). Fewer participants assigned to receive chewing gum than routine care experienced postoperative nausea (16 [31.4%] versus 29 [50.0%]; P=0.049) and postoperative ileus (0 vs. 5 [8.6%]; P=0.032). There were no differences in the need for postoperative antiemetics, episodes of postoperative vomiting, readmissions, repeat surgeries, time to first hunger, time to toleration of clear liquids, time to regular diet, time to first flatus, or time to discharge.
  
  
  CONCLUSIONS
  Chewing gum after laparotomy for gynecologic surgery is safe and lowers the incidence of postoperative ileus and nausea. ClinicalTrials.gov:NCT01579175.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: amelia.jernigan@gmail.com.
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Jernigan
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Chi Chiung Grace
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA; The US Food and Drug Administration, Center for Devices and Radiologic Health, Division of Reproductive, Gastro-Renal and Urologic Devices, Obstetrics and Gynecology Devices Branch, Silver Spring, MD, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sewell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002638:Chewing Gum; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000517:prevention & control*; D015994:Incidence; D007813:Laparotomy / Q000009:adverse effects*; D007902:Length of Stay; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D012086:Reoperation; D055815:Young Adult
chemical_list: D002638:Chewing Gum
keywords: Chewing gum; Gynecologic surgery; Ileus; Laparotomy