ABSTRACT

Objective To evaluate the efficacy and safety of postoperative gum chewing on the recovery of bowel motility after caesarean section.

Design A randomised controlled study.

Setting Faculty of Medicine, Ain Shams University, Egypt.

Population A total of 200 pregnant women delivered by elective caesarean section (CS) under general anaesthesia.

Methods Women were randomised into two groups; group A (93 women) who received one stick of sugarless gum for 15 minutes every 2 hours after surgery, and group B (107 women) had traditional management (oral intake of clear fluids allowed after passage of flatus and regular diet with the passage of bowel movement).

Main outcome measures Time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement and length of hospital stay.

Results The mean duration of surgery was longer in group A (41.3 ± 7.5 versus 38.4 ± 8.1 minutes, P < 0.05). The mean postoperative time interval to first hearing of normal intestinal sounds (10.9 ± 2.7 versus 15.6 ± 3.7 hours), passage of flatus (17.9 ± 4.6 versus 24.4 ± 7.1 hours), defecation (21.1 ± 4.7 versus 30 ± 8.2 hours) and discharge from the hospital (40.8 ± 10.6 versus 50.5 ± 8.9 hours) were significantly shorter in group A (P < 0.001). Severe ileus occurred only in one woman belonging to group B. All patients in group A tolerated gum chewing beginning on the first postoperative day.

Conclusion Gum chewing after CS is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stay; with potential impact on reducing the overall healthcare costs in case of routine implementation.