Chewing Gum Versus Standard Care for Enhanced Bowel Recovery After Cesarean Section: A Randomized Clinical Trial

Background and objective Cesarean sections (CS) are common and occasionally critical surgical procedures. Nausea, vomiting, and postoperative ileus (POI) frequently occur in patients undergoing cesarean delivery with regional anesthesia. These issues affect patient comfort, slow down wound healing, and prolong hospital stays. Studies have employed various strategies to address these challenges. Chewing gum post-surgery is a cost-effective approach to stimulate intestinal movement, promoting early initiation of oral intake, early mobilization, shorter hospital stays, and reduced overall hospitalization time. In this study, we aimed to investigate the potential benefits of chewing gum in this patient population. Methodology We randomly assigned a total of 314 women scheduled for elective or emergency lower segment CS (LSCS) to either a gum-chewing group (Group A, n=157) or a control group receiving standard postoperative care (Group B, n=157). Participants in the gum-chewing group chewed sugar-free gum for one hour postoperatively in sessions lasting 15 minutes each, continuing until bowel sounds resumed, and were allowed to have oral sips of water. In contrast, the control group's bowel sounds were checked every half hour till they appeared, and women were allowed to have sips of water once the bowel sounds were heard. The primary comparisons between the groups focused on the timing of first bowel sounds, first passage of flatus, and first bowel movement. Secondary endpoints included time to mobilization, removal of the catheter, and subjective sense of well-being. Results The average age of women in both groups was 24 years. There were no statistically significant differences between the study and control groups concerning age, parity, occupation, type of CS, reasons for CS, skin incision, or intraperitoneal adhesions. In Group A, the mean time for bowel sounds to appear was 3.39 hours, compared to 6.91 hours in Group B. For flatus passage, the mean time was 12.74 hours in Group A and 20.51 hours in Group B. Stool passage took an average of 41.59 hours in Group A and 64.03 hours in Group B. Conclusions Chewing gum, a type of simulated eating, is linked to faster restoration of gastrointestinal function following CS. This study elucidates the mechanisms behind the benefits of chewing gum and explores its potential in diverse surgical populations. Ultimately, integrating chewing gum into postoperative care may offer a valuable tool for enhancing patient outcomes and accelerating recovery, provided it is used in conjunction with comprehensive and personalized postoperative care strategies. It is a cost-effective approach that accelerates the recovery of intestinal movement post-surgery, decreasing the length of hospital stay and overall burden on patients.