Use of chewing gum in children undergoing an appendectomy: A randomized clinical controlled trial.
BACKGROUND
Post-operative ileus is a common condition among pediatric patients undergoing appendectomy. We aim to assess the feasibility, safety, and effectiveness of chewing gum to reduce ileus, and decrease time to oral tolerance.


METHODS
A randomized trial was conducted in 5-18 year old patients that underwent an appendectomy. Subjects in the intervention group received sugar-free chewing gum within the first 12 h after surgery and control group received the usual therapy. We assessed the acceptability of the intervention, time to pass first flatus, present first bowel movement, and time to tolerate oral intake.


RESULTS
A total of 41 patients were recruited, 21 in the intervention group and 20 in the control group. Mean time (SD) to first flatus in the intervention group was 17.18 h (8.18), and 24.37 h (17.53) in the control group (mean difference [MD] of -7.19 h; 95% CI, -15.7 to 1.38). Time to first bowel movement (MD, -4.6 h, 95%CI -18.5 to 9.3), time to tolerate oral intake (MD, 4.17 h; 95%CI -9.2 to 17.5), and length of hospital stay (MD, 6.9 h, 95%CI -19.1 to 33.1) appeared not to be affected by the intervention. Chewing gum was accepted, well tolerated, and without complications.


CONCLUSIONS
The use of chewing gum in children undergoing an appendectomy was safe and well tolerated and might lead to a faster recovery of bowel function, more studies are needed to prove if length of hospital stay and other outcomes are improved.
Department of Pediatrics, Tecnológico de Monterrey School of Medicine, Monterrey, NL, ISEM, Estado de México, Mexico. Electronic address: gabylopez7@gmail.com.
Gabriela
G
López-Jaimez
Tecnológico de Monterrey School of Medicine, Monterrey, NL, Mexico; Department of Clinical Epidemiology and Biostatistics McMaster University, Hamilton, ON, Canada.
Carlos A
CA
Cuello-García
D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects*; D002638:Chewing Gum; D002648:Child; D002675:Child, Preschool; D003672:Defecation; D005240:Feasibility Studies; D005260:Female; D005414:Flatulence; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011183:Postoperative Complications; D013997:Time Factors
D002638:Chewing Gum
Appendicitis; Chewing gum; Children; Post-operative ileus