title: The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section.
abstract: OBJECTIVE
  The goal of this study was to evaluate the effects of xylitol gum chewing on gastrointestinal recovery after cesarean section.
  
  
  METHODS
  Women who underwent cesarean section (N = 120) were randomly allocated into Group A (xylitol gum), Group B (nonxylitol gum), or the control group (no chewing gum). Every 2 hr post-cesarean section and until first flatus, Groups A and B received two pellets of chewing gum and were asked to chew for 15 min. The times to first bowel sounds, first flatus, and first defecation were then compared among the three groups.
  
  
  RESULTS
  Group A had the shortest mean time to first bowel sounds (6.9 ± 1.7 hr), followed by Group B (8 ± 1.6 hr) and the control group (12.8 ± 2.5 hr; one-way analysis of variance, p < .001; Scheffe's post hoc comparisons, p < .05). The gum-chewing groups demonstrated a faster return of flatus than the control group did (p < .001), but the time to flatus did not differ significantly between the gum-chewing groups. Additionally, the differences in the time to first defecation were not significant.
  
  
  CONCLUSIONS
  After cesarean section, chewing gum increased participants' return of bowel activity, as measured by the appearance of bowel sounds and the passage of flatus. In this context, xylitol-containing gum may be superior to xylitol-free gum.
authors.affiliation: School of Nursing, Chang Gung University, Taoyuan, Taiwan jtlee@mail.cgu.edu.tw.
authors.forename: Jian Tao
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Clinical Nurse, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Mei-Hui
authors.initials: MH
authors.lastname: Hsieh
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, University College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Cheng
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jr-Rung
authors.initials: JR
authors.lastname: Lin
mesh_terms: D000328:Adult; D002400:Cathartics / Q000494:pharmacology*; D002585:Cesarean Section; D002638:Chewing Gum; D003672:Defecation / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D011184:Postoperative Period; D011247:Pregnancy; D013624:Taiwan; D014993:Xylitol / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D002400:Cathartics; D002638:Chewing Gum; D014993:Xylitol
keywords: cesarean section; gum chewing; postoperative bowel activity