Effects of Gum Chewing on Post-Operative Ileus, Specifically Focusing on the Time Taken by the Patients to Pass Flatus After Their Ileostomy Reversal

Abstract

Background: Postoperative ileus after ileostomy reversal commonly delays recovery of gastrointestinal motility and prolongs hospitalization. Sham feeding through gum chewing may stimulate vagal activity and gastrointestinal hormone release, potentially accelerating bowel function recovery. Objective: To evaluate the effect of postoperative gum chewing on time to first passage of flatus after ileostomy reversal. Methods: This randomized controlled trial was conducted at the General Surgery Department, Unit-I, Lahore General Hospital, Lahore, from June 23, 2022, to December 23, 2022. Seventy patients aged 13–65 years undergoing ileostomy reversal for typhoid or tuberculous peritonitis were randomized into two groups (n=35 each). Group A received standard postoperative care without gum chewing, while Group B chewed gum for 30 minutes every 6 hours starting 6 hours after surgery. The primary outcome was time from surgery completion to first passage of flatus; secondary outcomes included length of hospital stay and duration of surgery. Results: Mean time to first flatus was significantly shorter in Group B than Group A (20.53±9.53 vs 33.27±19.47 hours; p<0.001), with an absolute mean reduction of 12.74 hours (95% CI −20.03 to −5.45). Hospital stay was also reduced (4.40±1.03 vs 5.68±1.07 days; p<0.001), while surgery duration did not differ significantly (p=0.566). Conclusion: Postoperative gum chewing significantly reduced time to first flatus and shortened hospital stay after ileostomy reversal, supporting its use as a safe and inexpensive adjunct to enhance postoperative recovery