A preliminary report has been interpreted to suggest that gum chewing reduces duration of postcolectomy ileus.
Dr Evan Matros and colleagues rigorously tested this hypothesis in a prospective, randomized, placebo-controlled study.
The research team randomized 66 patients undergoing open colectomy to receive 1 of 3 postoperative regimens beginning on postoperative day 1.
Group 1 included 21 controls who were randomized to sips only.
Group 2 included 23 patients randomized to sips and accupressure wrist bracelet, and 22 in Group 3 received sips and gum chewing.
|Time to first passage of flatus was 60 hours with gum chewing vs 67 hours in controls|
|Journal of the American College of Surgeons|
Patients were unaware of which regimen constituted placebo or treatment, and end points were assessed by blinded investigators.
The team set the power a priori at 85% to detect a 0.75-day difference in time to first postoperative passage of flatus between placebo and treatment groups.
The research team compared groups using the log-rank test.
The researchers reported that the groups were equivalent with respect to demographic and surgical characteristics.
Median time to first postoperative passage of flatus in Group 1 was 67 hours, 72 hours in Group 2, and 60 hours in Group 3.
The team observed no significant differences in time to passage of first bowel movement.
No significant difference was found in time until patients were ready for discharge, or time until actual discharge among the 3 groups.
The team demonstrated no difference with inpatient and 30-day follow-up in frequency or distribution of postoperative complications.
Dr Matros's team concluded, “In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.”