Document Detail


Gum chewing reduces postoperative ileus? A systematic review and meta-analysis.
MedLine Citation:
PMID:  19261555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An important cause of delayed recovery from intestinal surgery is postoperative ileus. Gum chewing is a form of sham feeding, which could encourage gastrointestinal motility through cephalic-vagal stimulation. METHODS: We sought to identify all randomized controlled trials comparing gum chewing with standard care after elective intestinal surgery. We searched electronic databases (Cochrane, Embase, and PubMed), reference lists and contacted authors to obtain further data. We assessed the identified trials for quality and performed a meta-analysis and systematic review. The main outcome measures examined were time to flatus and stool postoperatively and length of hospital stay, which were analysed using random effect models. We also examined clinical complication rates. RESULTS: We identified nine eligible trials that had enrolled a total of 437 patients. The intervention was well tolerated and complication rates were low. There was statistical evidence of heterogeneity for the three main outcomes. Pooled estimates showed a reduction in time to flatus by 14 h (95% CI: -20 to -8h, p=0.001), time to bowel movement by 23 h (95% CI: -32 to -15 h, p<0.001) and a reduction in length of hospital stay by 1.1 days (95% CI: -1.9 to -0.2 days, p=0.016). CONCLUSIONS: Chewing sugarless gum following elective intestinal resection is associated with improved outcomes. Insufficient data were available to demonstrate a reduced rate of clinical complications or reduced cost. An adequately powered, methodologically rigorous trial of gum chewing is required to confirm if there are any benefits and if these result in differences in clinical outcomes such as infection.
Authors:
Emma J Noble; Ros Harris; Ken B Hosie; Steve Thomas; Stephen J Lewis
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2009-01-31
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  7     ISSN:  1743-9159     ISO Abbreviation:  -     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-20     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  100-5     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, Derriford Hospital, Derriford Road, Plymouth, PL6 8DH, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Chewing Gum*
Child
Gastrointestinal Motility
Humans
Intestinal Pseudo-Obstruction / physiopathology,  therapy*
Mastication*
Middle Aged
Postoperative Complications / therapy
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Chewing Gum

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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