2005 Abstracts: Does Gum Chewing Ameliorate Postoperative Ileus?Results of a Prospective, Randomized Placebo-Controlled Trial
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Does Gum Chewing Ameliorate Postoperative Ileus?Results of a Prospective, Randomized Placebo-Controlled Trial
Flavio G. Rocha, Evan Matros, Stanley W. Ashley, Elizabeth Breen, Brent T. Shoji, David I. Soybel, Michael J. Zinner, Ronald Bleday, Edward E. Whang, Brigham and Women's Hospital, Boston, MA
Introduction:A recent report (J Am Coll Surg) has been interpreted to suggest that gum chewing reduces duration of post-colectomy ileus. We rigorously tested this hypothesis, because this finding, if validated, would have important clinical implications.
Methods: We used a prospective, randomized, placebo-controlled study design. Patients undergoing open colectomy (n = 66) were randomized to receive one of three postoperative regimens beginning on postoperative day 1: 1) sips (control), 2) sips + gum chewing (treatment), and 3) sips + acupressure wrist bracelet (placebo). Patients were unaware of which regimen constituted placebo or treatment; endpoints were assessed by blinded investigators. Power was set a priori at 85% to detect a 0.75 day difference in time to first postoperative passage of flatus between control and treatment groups. Groups were compared using the log rank test. Results: Groups were equivalent with respect to demographic and surgical characteristics. The median times to first postoperative passage of flatus were as follows: sips (67 hrs); bracelet and sips (72 hrs); gum and sips (60 hrs) [p=0.47]. There were no significant differences in time to passage of first bowel movement, time until patients were ready for discharge, or time until actual discharge among the three groups. Inpatient and follow-up at thirty days demonstrated no difference in the frequency or distribution of postoperative complications. Conclusions: Gum chewing does not reduce duration of post-colectomy ileus. These findings highlight the importance of conducting rigorous clinical trials in surgery before adopting new therapies. 
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