Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

Author(s):  
Dr.Randa Mohammed AboBaker

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

Author(s):  
Binti Bhatiyani ◽  
Pandeeswari . ◽  
Dolly Bhasani ◽  
Shrikant Dhumale

Background: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15%. Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of the hospitalisation period. This study aims to investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynaecologic surgery.Methods: 101 women who underwent laparoscopic surgery for benign gynaecological conditions under general anaesthesia were recruited. 50 patients received sugar free chewing gum post operatively and the outcomes were compared with the control group. The study’s primary end points were the time to first regular bowel sounds and time to passage of flatus after surgery. Secondary end points were the time to first defecation, patient satisfaction, and potential side effects of postoperative gum chewing.Results: We found a significantly shorter interval between surgery and passage of flatus in the intervention group (median 10 hours compared with 13 hours p=0.0151) and a significantly higher rate of regular bowel sounds 3 hours (74% compared with 45%; p= 0.003) and 5 hours after surgery (91% compared with 78%; p=0.01). There was no significant difference in time to first defecation between groups (median 18 hours compared with 20 hours; p=0.222).Conclusions: Gum chewing seems to have beneficial effects on bowel motility when used in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynaecological laparoscopic surgery


2020 ◽  
Vol 27 (09) ◽  
pp. 2001-2006
Author(s):  
Muhammad Kamran ◽  
Shahbaz Ahmad ◽  
Muhammad Faheem Anwer ◽  
Muhammad Hasan Anwaar ◽  
Muhammad Asif ◽  
...  

Post-operative ileus is a common compliant of patients at surgical floor. Studies have reported that gums chewing after abdominal surgeries decrease postoperative ileus (POI); but very few studies are available on role of chewing gum in ileostomy reversal cases. We concluded that post-operative gum chewing with standard post-operative care in patients undergoing elective surgery for ileostomy closure done for typhoid ileal perforation in terms of mean length of hospital stay and mean time of passage of first flatus is significantly better than those without gum chewing. Objectives: To compare post-operative gum chewing with standard care in cases having elective ileostomy closure in terms of mean length of hospital stay and mean time of passage of first flatus. Study Design: Randomized Control Trial. Setting: Department of Surgery, Allied Hospital Faisalabad. Period: 1st January 2017 to 31st December 2017. Material & Methods: Patients of 20 to 60 years undergoing elective surgery for typhoid ileal perforation were included in the study after informed consent. Two groups with A: allocated to chewing gum three times a day up to discharge; Control group: allocated to standard post-operative care without chew gum. Length of hospital stay and time of passage of first flatus was noted. Results: In this study, mean length of hospital stay in Chewing gum group was 7.73+0.74 days and 10.27+0.87 days in Control group, p value was 0.0001, mean time of passage of first flatus in Chewing gum group was 49.97+1.69 hrs and 89.17+2.07 hrs in Control group, p value was 0.0001. Conclusion: We concluded that post-operative gum chewing with standard post-operative care in patients undergoing elective surgery for ileostomy closure done for typhoid ileal perforation in terms of mean length of hospital stay and mean time of passage of first flatus is significantly better than those without gum chewing.


2020 ◽  
pp. 089719002097961
Author(s):  
Daniel Colon Hidalgo ◽  
Vishali Amin ◽  
Arushi Hukku ◽  
Kathryn Kutlu ◽  
Megan A. Rech

Introduction: Etomidate is commonly used for induction of anesthesia for rapid sequence intubation (RSI). It has little impact on hemodynamic status, making it a widely used agent. Due to the inhibition of cortisol production, etomidate causes adrenal suppression. The purpose of this study is to determine whether there is a correlation with etomidate use and the incidence of secondary infections. Methods: This was a retrospective cohort of hospitalized patients who received either etomidate or control (ketamine, propofol, or no agent) for RSI. The primary endpoint was the incidence of secondary infections. Secondary outcomes included number of mechanical ventilator-free days within 28 days, 30-day mortality, length of hospital stay, and length of intensive care unit stay. Results: A total of 434 patients were reviewed, of which 129 (29.7%) met the study criteria (n = 94 etomidate; n = 35 control). The incidence of secondary infection was numerically higher in the etomidate group compared with the control group, though this was not statistically significant (38.7% vs. 28.6%, p = 0.447). Also, though the secondary outcomes showed no statistically significant difference between the groups, the patients in the control group had a longer hospital stay (14.0 vs. 18.1, p = 0.20) and a longer ICU stay (11.0 vs. 14.1, p = 030). Furthermore, the etomidate group had a non-statistically significant higher incidence of bacteremia (8 vs. 0, p = 0.17) Conclusion: The use of etomidate was not associated with increased incidence of secondary infection. To fully understand the effects of etomidate use and its subsequent adrenal suppression, larger studies are needed.


2015 ◽  
Vol 53 (197) ◽  
pp. 24-27 ◽  
Author(s):  
Rajeev Bhandari ◽  
You Yong-hao

Introduction: Oesophageal resection were notoriously complicated and produces a cohort of patients prone to postoperative complications and here we would like to focus on the implementation and effectiveness of early chest tube removal in ERAS after oesophago-gastrectomy considering the various aspect like pleural effusion and reducing the length of hospital stay which ultimately lead to reducing the economic burden on patient.Methods: An ERAS programme was devised and implemented with the support of a dedicated in-hospital task-force. The patients underwent esophago-gastrectomy were randomly divided into two groups: the ERAS group and the control group (non-ERAS). The ERAS group was treated with early removal of the chest tube after surgery, and the control group was treated with traditional way and outcomes were compared between them.Results: The length of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group(p<0.05. However, there was no statistical significant difference in the incidences of pleural effusion between the two groups(p>0.05).Conclusions: The introduction of early chest tube removal as an ERAS programme after oesophago-gastrectomy would not increase the risk of pleural effusion and would not increase the total length of stay and cost of hospitalisation without jeopardising patient safety or clinical outcomes.


2020 ◽  
Author(s):  
Jin Li ◽  
Saroj Rai ◽  
Renhao Ze ◽  
Xin Tang ◽  
Ruikang Liu ◽  
...  

Abstract Background: Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields. However, there has been a paucity of research examining the application of ERAS in major pediatric orthopedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group. Methods: The ERAS group consisted of 86 patients included in the ERAS program from January 2016 to December 2017. The Control group consisted of 82 DDH patients who received osteotomies from January 2014 to December 2015. Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups. Results: The mean duration of hospital stay was significantly reduced from 10.0±3.1 in the traditional care group to 6.0±0.8 days in the ERAS(P<0.001). The VAS score in 3-day was significantly lower in ERAS group (2.9±0.8) than traditional non-ERAS group (4.0±0.8) (P<0.001). However, there was no significant difference in the frequency of breakout pain (VAS >4) between two groups (29.5±6.3 vs.30.6±6.5, P=0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery. Conclusion: The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.


2020 ◽  
Vol 12 (1) ◽  
pp. 26-34
Author(s):  
Shabnam Mohammad Pour ◽  
Sevil Hakimi ◽  
Abbas Delazar ◽  
Yousef Javad Zadeh ◽  
Fatemeh Mallah

Background: Pain and distress are two common complications of cesarean section. Among complementary therapies, Eremostachys was introduced as a pain mitigator. This study aimed at investigating the effect of Eremostachys laciniata on cesarean section pain and distress. Materials and methods: This randomized clinical trial was conducted on 86 women who gave childbirth by cesarean section. The control group received 50 mg rectal diclofenac suppository every 8 h for 3 days, and the intervention group received 35 mg E. laciniata total extract suppository every 8 h up to three doses. Pain was measured with the Visual Analogue Scale at 8, 16, and 24 h after cesarean section. The Symptom Distress Scale was completed at 8 and 24 h after cesarean section. The Redness, Edema, Ecchymosis, Discharge, Approximation scale was completed 5 days after cesarean section. Findings: Pain score at 8, 16, and 24 h after surgery (15 min after intervention) was not significantly different between the intervention and control groups. The distress score 24 h after cesarean section showed a significant difference in favor of the control group according to Friedman’s test. There was a significant difference between the two groups in wound healing score, which indicated better efficacy of rectal diclofenac suppository than E. laciniata suppository. We assessed nausea, vomiting, headache, massive hemorrhage, and any type of anaphylactic reaction. No side events were observed in two groups. Conclusion: Rectal E. laciniata suppository could be introduced as a low-complication, appropriate, and effective medication in controlling pain and distress after cesarean section; more studies should be conducted on this matter.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Nazila Najdi ◽  
Alireza Kamali ◽  
Pegah Eslami

Introduction: cesarean is one of the major surgeries after which mother will need to be hospitalized for a long period of time. One of the leading causes of the increase in the duration of hospitalization of such patients is the surgeons’ projections about the development of ileus and defecation. Given the previous studies, misoprostol can increase bowel movements. Moreover, gum-chewing has been recommended as a cheap and available technique for accelerating the resumption of normal Intestinal Movements. Methods and materials: the present study is a single-blind randomized clinical trial which has been done on 324 women over 18 years of age with singleton pregnancy who had visited Taleghani Hospital in Arak and was elective cesarean section candidates. The surgery and anesthesia techniques were similar for all patients. These patients were randomized into three groups of 108, namely control, misoprostol, and gum-chewing groups. The patients in these three groups were compared with one another in terms of normal bowel sound, gas passage, defecation and discharge. Results: the results have shown the mean age of a total of 324 patients has been 26.66 years. The results suggest that the time of hearing the first normal bowel sound, the first gas passage, and defecation have been shorter in the misoprostol group, gum-chewing group and control group, respectively. The difference observed between the three groups has been significant at a 0.05 significance level. Furthermore, no significant difference was observed between the patients in the misoprostol and gum-chewing groups and the patients in the control group while reviewing the time of discharge of these patients. Conclusion: the findings have been indicative of the positive effects of the misoprostol and gum-chewing techniques on the intestinal function of patients and mothers’ breastfeeding. Also, it has been observed that using misoprostol can be more effective than chewing gum.


2015 ◽  
Vol 18 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Jian Tao Lee ◽  
Mei-Hui Hsieh ◽  
Po-Jen Cheng ◽  
Jr-Rung Lin

Aims: The goal of this study was to evaluate the effects of xylitol gum chewing on gastrointestinal recovery after cesarean section. Methods: Women who underwent cesarean section ( N = 120) were randomly allocated into Group A (xylitol gum), Group B (nonxylitol gum), or the control group (no chewing gum). Every 2 hr post-cesarean section and until first flatus, Groups A and B received two pellets of chewing gum and were asked to chew for 15 min. The times to first bowel sounds, first flatus, and first defecation were then compared among the three groups. Results: Group A had the shortest mean time to first bowel sounds (6.9 ± 1.7 hr), followed by Group B (8 ± 1.6 hr) and the control group (12.8 ± 2.5 hr; one-way analysis of variance, p < .001; Scheffe’s post hoc comparisons, p < .05). The gum-chewing groups demonstrated a faster return of flatus than the control group did ( p < .001), but the time to flatus did not differ significantly between the gum-chewing groups. Additionally, the differences in the time to first defecation were not significant. Conclusion: After cesarean section, chewing gum increased participants’ return of bowel activity, as measured by the appearance of bowel sounds and the passage of flatus. In this context, xylitol-containing gum may be superior to xylitol-free gum.


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Daisuke Shigemi ◽  
Kazuho Nakanishi ◽  
Miwa Miyazaki ◽  
Yoshie Shibata ◽  
Shunji Suzuki

Lactulose is a non-digestible disaccharide formed from fructose and galactose. The objective of this study was to assess the effect of lactulose on gastrointestinal function after cesarean section. One hundred patients who underwent cesarean section at the Japanese Red Cross Katsushika Maternity Hospital were enrolled in this study. They were divided into 2 groups by randomization: (1) an L group that was treated with gelatinous lactulose (N = 48) and (2) a control group (C group) that did not receive gelatinous lactulose (N = 52). The interval between cesarean section and first postoperative flatus, defecation, and walking; appearance of symptoms of ileus; use of other medicines for stimulating bowel movement; properties and state of feces; and duration of postoperative hospital stay were compared between the two groups. The two groups did not show a significant difference in postoperative outcomes, except for the incidence of loose or watery stools (50% in the L group and 26.9% in the C group, P=0.03). This study could not demonstrate the apparent effectiveness of lactulose in improving bowel function after cesarean section. Therefore, a routine use of gelatinous lactulose after surgery may negatively impact the patients undergoing cesarean section.


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