feeding (when food is smelled
or chewed not swallowed) has been
demonstrated to be one of the methods to
increase bowel motility. It causes both vagal
stimulation and hormonal release; either one
or both could modulate the bowel motility.
Gum chewing, as an alternative to sham
feeding, provides the benefits of
gastrointestinal stimulation without the
complications associated with feeding. In
recent years, the use of chewing gum to
reduce the postoperative paralytic ileus has
been extensively reviewed in various
randomized controlled trials on elective
intestinal anastomosis and has been found
to be beneficial in reducing POI.7-10
The present study was aimed to
evaluate the effectiveness of chewing gum on
the bowel motility among patients who had
undergone abdominal surgery. Total sixty
subjects were studied prospectively for bowel
motility i.e return of first bowel sound,
passage of first flatus, return of appetite with
the administration of chewing gum to 30
subjects in the experimental group and routine
postoperative management to 30 subjects in
the control group. In the present study the
commercially available sugar-free chewing
gum (orbit) used same is used in the study
conducted by Marwah.6
The final outcome measures in the
present study are return of first bowel sound,
passage of first flatus and return of appetite
however, in systemic review by Hocevar et
al, the outcome measures were first time to
passage of flatus, time to passage of stool
and length of hospital stay.
11
In the present study, the patients were
asked to chew the gum starting from first
postoperative day thrice during a day till
passage of first flatus it is comparable to the
study Verified by State University of New York
- Upstate Medical University, June 2009 in
which chewing gum was also given thrice a
day starting from first postoperative day. In
Marwah study patients were asked to chew
gum thrice a day for 1 hour each time starting
from 6 hours after the surgery until the
passage of first flatus but in the present study,
here the patients were asked to chew gum
thrice a day for 15- 20min starting from 16
hrs after surgery until the passage of first
flatus.6
The duration of surgery is also a known
factor to cause POI. In the present study, the
operating time in all patients was 2-3 hours.
The mean duration of surgery was 2.68 ±
1.74 hours in the experimental group and 2.44
± 0.82 hours in the control group, which was
comparable in both groups. The results of
duration of surgery are comparable with most
of the previous studies except Ibrahim Harma
et al and Marwah et al where surgeries took
shorter duration (1-2 hrs) because of
caesarean section.In most of the studies, the
criteria for discharge of patients from hospital
were defecation, passage of gas, or feeding
tolerance. 6,12
The duration of anesthesia is another
known factor to cause POI. In the present
study, the mean duration of anesthesia was
109.3±41.95 minutes in the experimental
group and 112.8 ±55.7 minutes in the control
group, but there is no previous study where
the time of anesthesia was mentio