Gum chewing to prevent postoperative ileus after abdominal surgery; A multi-centre randomised single- blinded study.

Postoperative ileus is common after intra-abdominal surgery. It is
characterized by delayed passage of flatus and stool due to decreased bowel
activity. Prolonged delay in bowel function may lead to patient*s discomfort,
lengthened hospital stay and hospital-acquired infections . Recently, a
meta-analysis of 9 RCT*s on chewing gum after intra-abdominal surgery showed a
significant reduction in postoperative hospital stay (1.1 days), time to
passage of flatus and stool in the gum-chewing group. Also, the overall
infectious complications were reduced in this group , but data on this subject
were insufficiently reported. Although very promising, there is the possibility
of publication bias because the results were based exclusively on small and
heterogenic trials. Therefore a large well-designed randomized trial to compare
gum chewing with standard postoperative protocol is warranted.

In the Netherlands, gum chewing has not been incorporated in the standard
postoperative care after intra-abdominal surgery. Therefore a multi-center RCT
was set up to evaluate the influence of gum chewing on the development of
ileus. Our null hypothesis was that standard care and postoperative gum chewing
were equal, the alternative stated that they would not.
The main objective was:
- What is the influence of gum chewing on the length of postoperative hospital
stay (in hours)?
The secondary objectives were:
- What is the influence of gum chewing on the complication rate until 30 days
postoperatively?
- What is the influence of gum chewing on time to flatus, defecation and diet
tolerance (in hours)?
- What is the influence of gum chewing on postoperative pain perception?

Multicenter, single-blinded, randomized controlled trial in a clinical setting.

Little burden.
No side effects were mentions in any of the RCT's on gum chewing
daily fill in short questionlist in diary