Role of Chewing Gum in Reducing Post-Operative Ileus and Enhancing Recovery Following Colorectal Surgery – A Study at CMH Lahore

Authors

  • Hina Shaukat Surgical Unit -1, CMH, Lahore, Punjab, Pakistan.
  • Younas Awan Surgical Unit -1, CMH, Lahore, Punjab, Pakistan.
  • Danya Shaukat Department of Pathology, AFIP Rawalpindi, Punjab, Pakistan.
  • Muhammad Nouman Butt Surgical Unit -1, CMH, Lahore, Punjab, Pakistan.
  • Sajid Ali Khan PhD Scholar, UET Lahore, Punjab, Pakistan.
  • Khaula Rafeeq Alam Surgical Unit -1, CMH, Lahore, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i7.1369

Keywords:

Colorectal Surgery, Chewing Gum, Frequency, Ileus

Abstract

Objectives: To determine impact of chewing gum in immediate postoperative period on the outcomes of colorectal surgery. Study Design: Comparative cross-sectional study. Place and Duration of Study: Combined Military Hospital, Lahore from February 07, 2025 to May 07, 2025. Methodology: In this study, 62 patients who underwent elective colorectal surgery were included. They were divided into Group-G (advised to chew gum in addition to standard post-operative care) and Group-S (managed through standard post-operative care). Patients in both the groups were assessed for outcomes including duration to recover from physiologic postoperative ileus and the occurrence of pathologic postoperative ileus and their comparison was performed between groups. Data was analyzed using SPSS version 22.00. Results: In this study, 62 patients divided into two groups were included. Median age was 68.00 (7.00) years. There were 33 (53.20%) male and 29 (46.80%) female patients. In Group-G, median duration to pass first postoperative flatus was 37.00 (5.00) hours while in Group-S it was 58.00 (19.00) hours, (p < 0.001). In Group-G, median duration to pass first postoperative feces was 58.00 (5.00) hours while in Group-S it was 78.00 (5.00) hours, (p < 0.001). In Group-G (n = 31), pathological postoperative ileus occurred only in 1 (3.23%) patient while in Group-S (n = 31), it occurred in 8 (25.81%) patients, (p = 0.012). Conclusion: Addition of gum chewing to standard postoperative care after colorectal surgery can effectively reduce postoperative ileus rate and recovery time.

Downloads

Download data is not yet available.

References

1. Matsui, R., Nagakari, K., Igarashi, M., Hatta, R., Otsuka, T., Nomoto, J., Kohama, S., Azuma, D., Takehara, K., Mizuno, T., Ohuchi, M., Oka, S., Yoshimoto, J., Inaki, N., Fukunaga, M., & Ishizaki, Y. (2022). Impact of post-operative paralytic ileus on post-operative outcomes after surgery for colorectal cancer: A single-institution, retrospective study. Surgery Today, 52(12), 1731-1740.

https://doi.org/10.1007/s00595-022-02499-3

2. Wells, C. I., Milne, T. G., Seo, S. H., Chapman, S. J., Vather, R., Bissett, I. P., & O'Grady, G. (2021). Post‐operative ileus: Definitions, mechanisms and controversies. ANZ Journal of Surgery, 92(1-2), 62-68.

https://doi.org/10.1111/ans.17297

3. Abernethy, E. K., & Aly, E. H. (2024). Postoperative ileus after minimally invasive colorectal surgery: A summary of current strategies for prevention and management. Digestive Surgery, 41(2), 79-91.

https://doi.org/10.1159/000537805

4. Zhu, A., Bao, X., & Agarwala, A. (2019). Perioperative fluid management in the Enhanced Recovery After Surgery (ERAS) pathway. Clinics in Colon and Rectal Surgery, 32(02), 114-120.

https://doi.org/10.1055/s-0038-1676476

5. Canzan, F., Longhini, J., Caliaro, A., Cavada, M. L., Mezzalira, E., Paiella, S., & Ambrosi, E. (2024). The effect of early oral postoperative feeding on the recovery of intestinal motility after gastrointestinal surgery: A systematic review and meta-analysis of randomized clinical trials. Frontiers in Nutrition, 11.

https://doi.org/10.3389/fnut.2024.1369141

6. Li, K., Han, Y., Ullah, H., Chang, C., & Cao, L. (2024). Sham feeding as a nursing technology: Recent progress and future perspective. Interdisciplinary Nursing Research, 3(3), 135-140.

https://doi.org/10.1097/nr9.0000000000000067

7. Emile, S. H., Horesh, N., Garoufalia, Z., Gefen, R., Ray-Offor, E., & Wexner, S. D. (2024). Strategies to reduce ileus after colorectal surgery: A qualitative umbrella review of the collective evidence. Surgery, 175(2), 280-288.

https://doi.org/10.1016/j.surg.2023.10.005

8. Shereef, A., Raftery, D., Sneddon, F., Emslie, K., Mair, L., Mackay, C., Ramsay, G., & Forget, P. (2023). Prolonged ileus after colorectal surgery, a systematic review. Journal of Clinical Medicine, 12(18), 5769.

https://doi.org/10.3390/jcm12185769

9. HSU, Y., & SZU, S. (2022). Effects of gum chewing on recovery from postoperative ileus: A randomized clinical trail. Journal of Nursing Research.

https://doi.org/10.1097/jnr.0000000000000510

10. Wattchow, D., Heitmann, P., Smolilo, D., Spencer, N. J., Parker, D., Hibberd, T., Brookes, S. S., Dinning, P. G., & Costa, M. (2020). Postoperative ileus—An ongoing conundrum. Neurogastroenterology & Motility, 33(5).

https://doi.org/10.1111/nmo.14046

11. Elkan Kiyat, Z., & Kahyaoglu Sut, H. (2022). The effect of xylitol gum chewing after cesarean on bowel functions: A randomized controlled study. Journal of PeriAnesthesia Nursing, 37(6), 913-917.

https://doi.org/10.1016/j.jopan.2022.03.003

12. Wells, C. I., Milne, T. G., Seo, S. H., Chapman, S. J., Vather, R., Bissett, I. P., & O'Grady, G. (2021). Post‐operative ileus: Definitions, mechanisms and controversies. ANZ Journal of Surgery, 92(1-2), 62-68.

https://doi.org/10.1111/ans.17297

13. Alkan, S., Cakir, M., Şentürk, M., Varman, A., & Duyan, A. (2023). The efficacy and results of medical treatment in postoperative ileus. Nigerian Journal of Clinical Practice, 26(4), 497-501.

https://doi.org/10.4103/njcp.njcp_618_22

14. Ahmed, A., Khalid, S., Sharif, G., Ahmed, H. H., Khattak, I. A., & Memon, S. K. (2024). Efficacy of Enhanced Recovery After Surgery (ERAS) protocols in emergency colorectal surgery: A meta-analytical comparison with conventional care in terms of outcomes and complications. Cureus.

https://doi.org/10.7759/cureus.71630

15. Qin, J., Gou, L., Zhang, W., Pu, X., & Zhang, P. (2024). Enhanced Recovery After Surgery versus conventional care in cholecystectomy: A systematic review and meta-analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques, 34(8), 710-720.

https://doi.org/10.1089/lap.2024.0119

16. Shalata, W., Gluzman, A., Man, S., Cohen, A. Y., Abu Jama, A., Gothelf, I., Tourkey, L., Neime, A. E., Abu Juma’a, A., Peri-Hanania, K., Machluf, O., Shoham Levin, G., Shalata, S., Hayadri, A., Abu Zeid, E. E., Abu Yasin, N., Meirovitz, A., & Yakobson, A. (2024). Colorectal cancer in elderly patients: Insights into presentations, prognosis, and patient outcomes. Medicina, 60(12), 1951.

https://doi.org/10.3390/medicina60121951

17. Hawkins, A. T., Wise, P. E., Chan, T., Lee, J. T., Glyn, T., Wood, V., Eglinton, T., Frizelle, F., Khan, A., Hall, J., Ilyas, M. M., Michailidou, M., Nfonsam, V. N., Cowan, M. L., Williams, J., Steele, S. R., Alavi, K., Ellis, C. T., Collins, D., … Lightner, A. L. (2020). Diverticulitis: An update from the age old paradigm. Current Problems in Surgery, 57(10), 100862.

https://doi.org/10.1016/j.cpsurg.2020.100862

18. Waldmann, E., Jiricka, L., Zessner-Spitzenberg, J., Majcher, B., Rockenbauer, L., Penz, D., Hinterberger, A., Trauner, M., & Ferlitsch, M. (2024). Differences between men and women with respect to colorectal cancer mortality despite screening colonoscopy. Gastrointestinal Endoscopy, 99(6), 998-1005.e2.

https://doi.org/10.1016/j.gie.2024.01.001

19. Kusika, N. P., Hutagaol, I. E., Yusuf, M., Suyanto, S., & Tilusari, S. P. (2021). The role of chewing gum on post-operative bowel recovery after Gynecological Laparoscopic surgery: A short report and updated review. Open Access Macedonian Journal of Medical Sciences, 9(B), 1123-1127.

https://doi.org/10.3889/oamjms.2021.7133

20. Muwel, S., Suryavanshi, S., Damde, H. K., Mishra, A., Yadav, S. K., & Sharma, D. (2024). Effect of chewing gum in reducing postoperative ileus after gastroduodenal perforation peritonitis surgery: A prospective randomised controlled trial. Tropical Doctor, 54(3), 237-244.

https://doi.org/10.1177/00494755241245456

21. Atkinson, C., Penfold, C. M., Ness, A. R., Longman, R. J., Thomas, S. J., Hollingworth, W., Kandiyali, R., Leary, S. D., & Lewis, S. J. (2016). Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. British Journal of Surgery, 103(8), 962-970.

https://doi.org/10.1002/bjs.10194

22. Van den Heijkant, T. C., Costes, L. M., Van der Lee, D. G., Aerts, B., Osinga-de Jong, M., Rutten, H. R., Hulsewé, K. W., De Jonge, W. J., Buurman, W. A., & Luyer, M. D. (2015). Randomized clinical trial of the effect of gum chewing on postoperative ileus and inflammation in colorectal surgery. Journal of British Surgery, 102(3), 202-211.

https://doi.org/10.1002/bjs.9691

Downloads

Published

2025-07-10

Issue

Vol. 3 No. 7 (2025): IJBR

Section

Original Article

License

Copyright (c) 2025 Indus Journal of Bioscience Research

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Shaukat , H., Awan , Y., Shaukat , D., Butt, M. N., Khan , S. A., & Alam, K. R. (2025). Role of Chewing Gum in Reducing Post-Operative Ileus and Enhancing Recovery Following Colorectal Surgery – A Study at CMH Lahore. Indus Journal of Bioscience Research, 3(7), 62-66. https://doi.org/10.70749/ijbr.v3i7.1369