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Chewing gum linked to surgery recovery

By Laura Crowley , 19-Aug-2008

Chewing gum may help in the recovery of intestinal function following surgery to remove all or part of the colon, according to an analysis of studies on the topic.

The recent analysis, published in the August issue of Archives of Surgery, reviewed five studies involving a total of 158 patients where the test groups chewed sugarless gum three times a day following surgery for a period of between five and 45 minutes.

The studies looked at how the time to the first passage of flatus, time to the first bowel movement and the length of postoperative stay varied between the test group and those patients who did not chew gum.

Postoperative ileus - the inability of the intestines to pass contents – is a common response to the trauma of abdominal surgery and is a major contributing factor to postoperative pain and discomfort.

According to the report, current methods of relief are extremely expensive, and in England, more than 31 000 colorectal resections performed from 2004 to 2005. The range of mean length of stay for these patients was between 13 and 26 bed-days. Chewing gum could provide a cheaper alternative.

Chewing gum is thought to stimulate nerves in the digestive system, promoting the release of gastrointestinal hormones and thereby increasing the production of saliva and secretions from the pancreas, the authors wrote.

They said: “We feel that the current evidence suggests that gum chewing following abdominal surgery offers significant benefits in reducing the time to resolution of ileus; however, the studies are insufficiently powered to identify a significant benefit in length of stay.”

The latest study adds to a growing volume of research showing benefits from gum-chewing, including research published by Wrigley last November which claimed that chewing a stick of gum can help focus and sharpen the mind, ultimately helping to improve memory recall.

Meanwhile, in September three of Wrigley’s sugar-free chewing gums became the first in the US to earn the American Dental Association’s seal of approval, underlining claims that chewing gum can help with oral health.

The analysis

Chewing gum has been used unsuccessfully in the past to improve postoperative recovery from tonsillectomy.

However, the potential of chewing gum for postoperative recovery in patients undergoing colorectal surgery has received much public and media attention recently.

Researchers from St Mary’s Hospital, London, searched Medline, Embase, Ovid, and Cochrane databases to identify randomised studies comparing the effects of chewing gum on patients who have undergone colectomy.

Results of the meta-analysis showed that both the time for to pass flatus and the time until the first bowel movement were significantly reduced for patients who chewed gum, compared with the control group.

The length of hospital stay after the operation was assessed in four trials with a total of 134 patients. Those who were given chewing gum were found to spend one less day in hospital. However, this result was not statistically significant so this effect could have been due to chance, said the researchers.

The report concluded: “The potential benefits to individual patients, in health economics terms, are such that a well-designed, large-scale, blinded, randomized, controlled trial with a placebo arm is warranted to answer the question of whether gum chewing can significantly reduce the length of stay after abdominal surgery or whether it merely represents a placebo effect.”

Source: Archives of Surgery
August 2008; 143(8):788-793.
“Meta-analysis of Randomized Studies Evaluating Chewing Gum to Enhance Postoperative Recovery Following Colectomy”
Authors: S. Purkayastha, H. Tilney, A. Darzi, P. Tekki

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