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Rob Schuster, MD; Nina Grewal, MD; Gregory C. Greaney, MD; Kenneth Waxman, MD

Arch Surg. 2006;141:174-176.

Hypothesis  Gum chewing after elective open colon resection may stimulate bowel motility and decrease duration of postoperative ileus.

Design and Setting  Prospective, randomized study in a community-based teaching hospital.

Patients  Thirty-four patients undergoing elective open sigmoid resections for recurrent diverticulitis or cancer.

Main Outcome Measures  First feelings of hunger, time to first flatus, time to first bowel movement, length of hospital stay, and complications.

Results  A total of 34 patients were randomized into 2 groups: a gum-chewing group (n = 17) or a control group (n = 17). The patients in the gum-chewing group chewed sugarless gum 3 times daily for 1 hour each time until discharge. Patient demographics, intraoperative, and postoperative care were equivalent between the 2 groups. All gum-chewing patients tolerated the gum. The first passage of flatus occurred on postoperative hour 65.4 in the gum-chewing group and on hour 80.2 in the control group (P = .05). The first bowel movement occurred on postoperative hour 63.2 in the gum-chewing group and on hour 89.4 in the control group (P = .04). The first feelings of hunger were felt on postoperative hour 63.5 in the gum-chewing group and on hour 72.8 in the control group (P = .27). There were no major complications in either group. The total length of hospital stay was shorter in the gum-chewing group (day 4.3) than in the control group (day 6.8), (P = .01).

Conclusions  Gum chewing speeds recovery after elective open sigmoid resection by stimulating bowel motility. Gum chewing is an inexpensive and helpful adjunct to postoperative care after colectomy.

Author Affiliations: Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, Calif.

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