Gum-chewing after elective laparotomy with gut anastomosis in surgical patients

Background: Gum-chewing has been listed as one of many factors that contribute to enhancing recovery after laparotomy due to its effects on postoperative ileus.

Objectives: The aim of the study was to compare gum-chewing against controls on the reduction of postoperative ileus among patients undergoing elective laparotomy.

Methodology: Consenting patients who had elective laparotomy with gut anastomosis in the Surgical wards of Nnamdi Azikiwe University Teaching Hospital(NAUTH),  Nnewi were randomised into Gum-chewing group and Control/ traditional delayed feeding group. In the first Group patients’ Naso gastric tubes(NGT) were left insitu as they chewed gum 3 times a day from 1DPO. Patients in the second group were used as controls and were managed in the traditional way-nil by mouth until passage of flatus or faeces. Assessed outcome measure was time from completion of surgery to passage of flatus and faeces.

Results: During the study period, December 2014 to November 2016 (2 years), 70 consenting patients who had elective laparotomy in the Surgical wards were randomised into the two groups- Group 1 (n=34) and group 2 (n=36). The groups were similar in terms of gender, age, surgical procedures, and co morbidity. The age range was 20-81 years. The time from completion of surgery to first passage of flatus was 3.07days for Group 1 and 3.92days for Group 2. Time from completion of surgery to first passage of stool was 4.00days for Group1 and 4.76days for Group2. Time to flatus and faeces was significantly shorter in the Gum-chewing group compared to Controls (p0.05 for both). There were no significant differences noted in the complication rates among the groups.

Conclusion: Gum-chewing reduced the length of postoperative ileus significantly