Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women : a randomized clinical trial

Background : gum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus. Objectives : the current study assessed the effect of chewing sugar-free gum on the return of bowel function, where cesarean section had been performed in nulliparous women. Materials and Methods : in a randomized clinical trial, 60 patients, scheduled for cesarean section were randomly divided in to 2 groups gum-chewing group (n = 30) and control group (n = 30) postoperatively. The patients in the gum-chewing group postoperatively chewed sugar free gum 3 times daily each time for 1 hour until discharge. the patients' demographic characteristics, duration of surgery, mean hunger time, flatus and bowel motility were compared in the two groups. Results : there was no significant difference between the 2 groups regarding patient demographics, intraoperative, and postoperative care. In the gum-chewing and the control group there was a significant difference in the mean postoperative interval of the first bowel movement (20.89 ± 8.8 versus 27.93 ± 9.3 hours, P = 0.004), the first feeling of hunger (10.37 ± 6.0 versus 16.33 ± 9.3 hours, P = 0.005), the first passage of flatus (25.02 ± 5.8 versus 31.08 ± 9.7 hours, P = 0.003), and the first defecation (31.17 ± 5.3versus 40.08 ± 8.8 hours, P = 0.000) respectively, which were significantly shorter in the gum-chewing group compared to those of the control group. There were no major complications in either group. All patients in the gum-chewing group tolerated it without any major complications and side effects. Conclusions : the study results demonstrated that bowel motility after cesarean section in nulliparous women can be accelerated by gum chewing which is a useful, inexpensive and well-tolerated method for mothers in post-cesarean section.