Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial

Evan Matros, Flavio Rocha, Michael Zinner, John Wang, Stanley Ashley, Elizabeth Breen, David Soybel, Brent Shoji, Anne Burgess, Ronald Bleday, Richard Kuntz, Edward Whang

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background: A preliminary report has been interpreted to suggest that gum chewing reduces duration of postcolectomy ileus. Study design: We rigorously tested this hypothesis in a prospective, randomized, placebo-controlled study. Patients undergoing open colectomy (n = 66) were randomized to receive 1 of 3 postoperative regimens beginning on postoperative day 1: sips (control, n = 21); sips and accupressure wrist bracelet (placebo, n = 23); and sips and gum chewing (treatment, n = 22). Patients were unaware of which regimen constituted placebo or treatment; end points 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 placebo and treatment groups. Groups were compared using the log-rank test. Results: Groups were equivalent with respect to demographic and surgical characteristics. Median times to first postoperative passage of flatus were as follows: sips, 67 hours; bracelet and sips, 72 hours; gum and sips, 60 hours (p = 0.384). 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 30-day followup demonstrated no difference in frequency or distribution of postoperative complications. Conclusions: In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.

Original languageEnglish (US)
Pages (from-to)773-778
Number of pages6
JournalJournal of the American College of Surgeons
Volume202
Issue number5
DOIs
StatePublished - May 1 2006

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Chewing Gum
Ileus
Randomized Controlled Trials
Placebos
Flatulence
Colectomy
Gingiva
Wrist
Inpatients
Therapeutics
Research Personnel
Demography
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Matros, Evan ; Rocha, Flavio ; Zinner, Michael ; Wang, John ; Ashley, Stanley ; Breen, Elizabeth ; Soybel, David ; Shoji, Brent ; Burgess, Anne ; Bleday, Ronald ; Kuntz, Richard ; Whang, Edward. / Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial. In: Journal of the American College of Surgeons. 2006 ; Vol. 202, No. 5. pp. 773-778.
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abstract = "Background: A preliminary report has been interpreted to suggest that gum chewing reduces duration of postcolectomy ileus. Study design: We rigorously tested this hypothesis in a prospective, randomized, placebo-controlled study. Patients undergoing open colectomy (n = 66) were randomized to receive 1 of 3 postoperative regimens beginning on postoperative day 1: sips (control, n = 21); sips and accupressure wrist bracelet (placebo, n = 23); and sips and gum chewing (treatment, n = 22). Patients were unaware of which regimen constituted placebo or treatment; end points 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 placebo and treatment groups. Groups were compared using the log-rank test. Results: Groups were equivalent with respect to demographic and surgical characteristics. Median times to first postoperative passage of flatus were as follows: sips, 67 hours; bracelet and sips, 72 hours; gum and sips, 60 hours (p = 0.384). 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 30-day followup demonstrated no difference in frequency or distribution of postoperative complications. Conclusions: In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.",
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Matros, E, Rocha, F, Zinner, M, Wang, J, Ashley, S, Breen, E, Soybel, D, Shoji, B, Burgess, A, Bleday, R, Kuntz, R & Whang, E 2006, 'Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial', Journal of the American College of Surgeons, vol. 202, no. 5, pp. 773-778. https://doi.org/10.1016/j.jamcollsurg.2006.02.009

Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial. / Matros, Evan; Rocha, Flavio; Zinner, Michael; Wang, John; Ashley, Stanley; Breen, Elizabeth; Soybel, David; Shoji, Brent; Burgess, Anne; Bleday, Ronald; Kuntz, Richard; Whang, Edward.

In: Journal of the American College of Surgeons, Vol. 202, No. 5, 01.05.2006, p. 773-778.

Research output: Contribution to journalArticle

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T1 - Does Gum Chewing Ameliorate Postoperative Ileus? Results of a Prospective, Randomized, Placebo-Controlled Trial

AU - Matros, Evan

AU - Rocha, Flavio

AU - Zinner, Michael

AU - Wang, John

AU - Ashley, Stanley

AU - Breen, Elizabeth

AU - Soybel, David

AU - Shoji, Brent

AU - Burgess, Anne

AU - Bleday, Ronald

AU - Kuntz, Richard

AU - Whang, Edward

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N2 - Background: A preliminary report has been interpreted to suggest that gum chewing reduces duration of postcolectomy ileus. Study design: We rigorously tested this hypothesis in a prospective, randomized, placebo-controlled study. Patients undergoing open colectomy (n = 66) were randomized to receive 1 of 3 postoperative regimens beginning on postoperative day 1: sips (control, n = 21); sips and accupressure wrist bracelet (placebo, n = 23); and sips and gum chewing (treatment, n = 22). Patients were unaware of which regimen constituted placebo or treatment; end points 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 placebo and treatment groups. Groups were compared using the log-rank test. Results: Groups were equivalent with respect to demographic and surgical characteristics. Median times to first postoperative passage of flatus were as follows: sips, 67 hours; bracelet and sips, 72 hours; gum and sips, 60 hours (p = 0.384). 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 30-day followup demonstrated no difference in frequency or distribution of postoperative complications. Conclusions: In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.

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