Gum chewing: another simple potential method for more rapid improvement of postoperative gastrointestinal function

BACKGROUND: Sham feeding has been reported to enhance bowel motility. Here, to promote gastrointestinal function after postoperative ileus, the effect of gum chewing (GC) was evaluated.

METHODS: Literature search including PubMed, Embase, Science Citation Index, SpringerLink, and secondary sources. Fixed-effect and random-effects models were used to measure the pooled estimates. The test of heterogeneity was performed with the Q statistic. Stratified and sensitivity analyses were performed to explore heterogeneity between studies and to assess effects of study quality.

RESULTS: GC was well tolerated in a total of 1,148 cases in this meta-analysis. The pooled weighted mean difference for time to first flatus and bowel movement in GC was found to be -9.21 (95% CI: -12.07 to -6.34; p < 0.01) and -11.42 (95% CI: -16.05 to -6.79; p < 0.01), respectively, compared to standardized postoperative care. The intervention also decreased length of hospitalization by 12.23 h (95% CI: -18.80 to -5.67; p = 0.0003). Subgroup analyses for different abdominal procedures all favored GC.

CONCLUSION: This meta-analysis demonstrated that GC was safe and easily tolerated without any complications following abdominal surgery to potentially shorten postoperative ileus.