EFFECT OF CHEWING GUM ON GASTROINTESTINAL RECOVERY FOLLOWING ELECTIVE GYNECOLOGICAL ABDOMINAL SURGERIES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: To assess the effectiveness of postoperative chewing gum in accelerating gastrointestinal recovery among women undergoing elective gynecological transabdominal surgeries.

Methods: This was a prospective, single-center, randomized controlled trial conducted at Saveetha Medical College & Hospitals, enrolling 50 adult female patients (aged 20–60 years) undergoing elective cesarean section or total abdominal hysterectomy. Participants were randomized into two equal groups (n=25 each): Group A (intervention) received sugar-free chewing gum for 20 minutes, three times daily, starting 6 hours post-surgery until first stool or 72 hours, while Group B (control) received standard postoperative care. Primary outcomes included time to first bowel sound, flatus, and defecation. Secondary outcomes were length of hospital stay, need for prokinetic drugs, and patient satisfaction (1–5 Likert scale). Nursing staff blinded to group allocation recorded outcomes. Data were analyzed using Student's t-test, Chi-square, or Fisher’s exact test, with significance set at p<0.05.

Results: Baseline characteristics were comparable between groups. The chewing gum group demonstrated significantly faster gastrointestinal recovery. Mean time to first bowel sound was 9.4±2.1 hours in the chewing gum group vs. 13.6±2.8 hours in controls (p=0.001). Mean time to passage of flatus was 17.2±3.6 hours vs. 22.8±4.1 hours (p=0.003), and mean time to first defecation was 29.5±5.8 hours vs. 37.3±6.1 hours (p=0.002). Secondary outcomes also favored the intervention: mean hospital stay was significantly shorter (2.4±0.6 days vs. 3.1±0.9 days; p=0.014), and fewer patients required prokinetic drugs (8% vs. 28%; p=0.045). Patient satisfaction was significantly higher in the chewing gum group, with 60% reporting the highest score (5) vs. 28% in controls (p=0.016).

Conclusion: Postoperative chewing gum significantly accelerates gastrointestinal recovery, shortens hospital stay, reduces the need for prokinetic agents, and improves patient satisfaction among women undergoing elective gynecological abdominal surgeries. This simple, safe, and cost-effective intervention can be a valuable adjunct to enhance postoperative care in this patient population.