Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

YUAN Yuanxia ¹ ,  ZHAO Hongli ¹ , HE Jia ² , GONG Dian ¹

1. Department of Obstetrics and Gynecology, Meishan People’s Hospital, Chengdu 610041, China; 2. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

ZHAO Hongli, Email: mshonny0701@126.com

Keywords：

Cesarean section; Chewing gum; Postoperative ileus; Bowel function; Systematic review

DOI：

10.7507/1672-2531.20110074

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the efficacy and safety of chewing gum in promoting bowel recovery after cesarean section.
Methods 　Such databases as The Cochrane Library, MEDLINE, EMbase and CBM were searched from their establishment to 2010 to include the randomized controlled trials (RCTs) of comparing chewing gum with other procedures for promoting postoperative bowel function after cesarean section. The risks of bias in the included studies were evaluated at randomization, allocation concealment, blinding, completeness of outcomes, and selective reporting. Meta-analyses were performed by RevMan 5.0.22 software.
Results 　Three RCTs involving 745 participants were included. The results of meta-analyses showed chewing gum after cesarean section significantly shortened the time before getting the first postoperative flatus (MD= –6.54, 95%CI –7.82 to –5.27, P lt;0.000 01), reduced the risks of postoperative ileus (RR=0.54, 95%CI 0.34 to 0.87, P=0.01) and possibly shortened the length of hospital stay (MD= –0.21, 95%CI –0.39 to –0.03, P=0.02) compared with blank control. Currently, no adequate data supported the safety of chewing gum after cesarean section.
Conclusion 　Chewing gum after cesarean section can promote the postoperative bowel recovery, and reduce the odds of postoperative ileus. However, more high quality RCTs are required for lack of included studies and poor quality of methodology.

Citation： YUAN Yuanxia,ZHAO Hongli,HE Jia,GONG Dian. Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(4): 427-432. doi: 10.7507/1672-2531.20110074 Copy

1.	1 Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al . Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet , 2010, 375(9713): 490-499.
2.	Teoh WHL, Shah MK, Mah CL. A randomised controlled trial on beneficial effects of early feeding post-Caesarean delivery under regional anaesthesia. Singapore Med J , 2007, 48(2):152-157.
3.	Kehlet H. Postoperative ileus--an update on preventive techniques. Nat Clin Pract Gastroenterol Hepatol , 2008, 5(10): 552-558.
4.	Izbizky GH, Minig L, Sebastiani MA, et al . The effect of early versus delayed post-caesarean feeding on women’s satisfaction: a randomised controlled trial. BJOG , 2008, 115(3): 332-338.
5.	Schuster R, Grewal N, Greaney GC, et al . Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg , 2006, 141(2): 174-176.
6.	Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg , 2009, 13(4): 649-656.
7.	Purkayastha S, Tilney HS, Darzi AW, et al . Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg , 2008, 143(8): 788-793.
8.	Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum , 2007, 50(12): 2149-2157.
9.	de Castro SM, van den Esschert JW, van Heek NT, et al . A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg , 2008, 25(1): 39-45.
10.	Fitzgerald JE, Ahmed I. Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg , 2009, 33(12): 2557-2566.
11.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12.	Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, et al . Gum chewing stimulates early return of bowel motility after caesarean section. BJOG , 2009, 116(10):1334-9.
13.	Kafali H, Duvan CI, Gözdemir E, et al . Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest , 2010, 69(2): 84-87.
14.	Shang H, Yang Y, Tong X, et al . Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol , 2010, 27(5): 387-391.
15.	Carr CS, Ling KD, Boulos P, et al . Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection. BMJ , 1996, 312(7035): 869-871.
16.	Stewart BT, Woods RJ, Collopy BT, et al . Early feeding after elective open colorectal resections: a prospective randomized trial. Aust N Z J Surg , 1998, 68(2): 125-128.
17.	Basse L, Hjort Jakobsen D, Billesbølle P, et al . A clinical pathway to accelerate recovery after colonic resection. Ann Surg , 2000, 232(1): 51-57.
18.	Milov DE, Andres JM, Erhart NA, et al . Chewing gum bezoars of the gastrointestinal tract. Pediatrics , 1998, 102(2): e22.
19.	Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum--an unfortunate combination. Med J Aust , 2007, 187(11-12): 635.
20.	Matros E, Rocha F, Zinner M, et al . Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg , 2006, 202(5): 773-778.

1. 1 Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al . Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet , 2010, 375(9713): 490-499.
2. Teoh WHL, Shah MK, Mah CL. A randomised controlled trial on beneficial effects of early feeding post-Caesarean delivery under regional anaesthesia. Singapore Med J , 2007, 48(2):152-157.
3. Kehlet H. Postoperative ileus--an update on preventive techniques. Nat Clin Pract Gastroenterol Hepatol , 2008, 5(10): 552-558.
4. Izbizky GH, Minig L, Sebastiani MA, et al . The effect of early versus delayed post-caesarean feeding on women’s satisfaction: a randomised controlled trial. BJOG , 2008, 115(3): 332-338.
5. Schuster R, Grewal N, Greaney GC, et al . Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg , 2006, 141(2): 174-176.
6. Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg , 2009, 13(4): 649-656.
7. Purkayastha S, Tilney HS, Darzi AW, et al . Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg , 2008, 143(8): 788-793.
8. Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum , 2007, 50(12): 2149-2157.
9. de Castro SM, van den Esschert JW, van Heek NT, et al . A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg , 2008, 25(1): 39-45.
10. Fitzgerald JE, Ahmed I. Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg , 2009, 33(12): 2557-2566.
11. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12. Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, et al . Gum chewing stimulates early return of bowel motility after caesarean section. BJOG , 2009, 116(10):1334-9.
13. Kafali H, Duvan CI, Gözdemir E, et al . Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest , 2010, 69(2): 84-87.
14. Shang H, Yang Y, Tong X, et al . Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol , 2010, 27(5): 387-391.
15. Carr CS, Ling KD, Boulos P, et al . Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection. BMJ , 1996, 312(7035): 869-871.
16. Stewart BT, Woods RJ, Collopy BT, et al . Early feeding after elective open colorectal resections: a prospective randomized trial. Aust N Z J Surg , 1998, 68(2): 125-128.
17. Basse L, Hjort Jakobsen D, Billesbølle P, et al . A clinical pathway to accelerate recovery after colonic resection. Ann Surg , 2000, 232(1): 51-57.
18. Milov DE, Andres JM, Erhart NA, et al . Chewing gum bezoars of the gastrointestinal tract. Pediatrics , 1998, 102(2): e22.
19. Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum--an unfortunate combination. Med J Aust , 2007, 187(11-12): 635.
20. Matros E, Rocha F, Zinner M, et al . Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg , 2006, 202(5): 773-778.

Previous Article
The Effect of Music Therapy for Childbirth: A Meta-analysis
Next Article
Association of Apolipoprotein E Polymorphism and Alzheimer’s Disease in Chinese Population: A Meta-analysis

Chinese Journal of Evidence-Based Medicine

Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content