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Vol. 25, No. 1, 2008
Issue release date: April 2008
Dig Surg 2008;25:39–45

A Systematic Review of the Efficacy of Gum Chewing for the Amelioration of Postoperative Ileus

de Castro S.M.M. · van den Esschert J.W. · van Heek N.T. · Dalhuisen S. · Koelemay M.J.W. · Busch O.R.C. · Gouma D.J.
aAcademic Medical Center of the University of Amsterdam, and bTergooi Hospital, Hilversum, The Netherlands

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Background: Recent trials have shown promising results for the efficacy of gum chewing for the amelioration of postoperative ileus. This finding could have a major clinical impact since gum chewing is relatively harmless and cheap while postoperative ileus has a significant impact on healthcare. Methods: Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of gum chewing after colorectal surgery to a standard control for the amelioration of postoperative ileus, expressed as time to flatus, time to defecation and overall hospital stay. Results: Five randomized controlled trials with a total number of 158 patients were found. The studies were homogeneous and a meta-analysis was performed. The pooled weighted mean difference (WMD) of time to flatus was significantly shorter for the gum-chewing group (20 h with a 95% confidence interval (CI) of 13–27). The pooled WMD of time to defecation was significantly shorter (29 h, 95% CI of 19–39). There was a non-significant trend towards a shorter postoperative hospital stay (1.3 days shorter, 95% CI of 3.2 days shorter to 0.6 days longer). Conclusion: This meta-analysis shows a favorable effect of gum chewing on time to flatus and defecation but no significant effect on the hospital stay.

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