Chewing gum reduces postoperative ileus after open appendectomy.

HYPOTHESIS: It is suggested that chewing gum may accelerate postoperative intestinal transit recovery. Chewing gum may therefore produce the same result after open appendectomy.

DESIGN AND SETTING: Prospective, randomized study in a University teaching hospital.

PATIENTS: 46 patients operated on by open appendectomy due to acute catarrhal appendicitis, appendicular abscess and appendicular generalized peritonitis.

MAIN OUTCOME MEASURES: Interest was in occurrence of first flatus, first bowel movement, hospital duration and complications.

RESULTS: A total of 46 patients were randomly divided into two groups: a chewing gum group (n=23) and a control group (n=23). In the first group, patients chewed sugarless gum for 30 minutes thrice daily until resumption of intestinal transit. Patient demographics, intra-operative, and postoperative care were the same for both groups. Chewing gum was well tolerated by all the patients. The first passage of flatus occurred on postoperative day 2.2 in the gum-chewing group and on day 3.0 in the control group (P < 0.0001). The first bowel movement occurred at postoperative day 2.3 in the chewing gum group and at postoperative day 3.3 in the control group (P < 0.0001). Five complications were noted overall. Hospital stay was shorter in the chewing gum group (4.9 days.) than in the control group (6.7 days), (P < 0.0001).

CONCLUSION: Chewing gum ameliorates recovery after open appendectomy by reducing postoperative ileus. It is a cheap and helpful treatment to be recommended in developing countries in Africa.