| Summary: | Objective: To compare the additional use of gum chewing with standard post-operative care in management of post-operative bowel ileus in Thai gynecological patients undergoing abdominal surgery.
Methods: A total of 128 patients were recruited in this study. Eligible patients were randomly assigned to one of two groups; group A received standard post-operative care and group B received gum chewing with standard post-operative care. Each patient was asked to complete a questionnaire on demographic data. Data about diagnosis, operation, anesthetic method, blood loss, analgesic drugs, and antiflatulants were obtained from operative notes, anesthetic notes, and medical records. Results: The first passage of blenching and flatus was noted post-operatively at hours 14.7 and 16.1 in group B, and 19.2 and 19.9 in group A, respectively. Patients in group B had significantly higher number of blenching, flatus, and bowel sound than those in group A in every time point assessment, except the number of flatus in post-operative day 3 which was not significantly different. Patients in group A had significantly higher abdominal distention score than those in group B in every time point assessment. Increased waist circumference was significantly higher in group A than group B in post-operative days 2 and 3. Patients in group A had significantly more severity of ileus than those in group B in post-operative days 1-3. Patients in group B had higher satisfaction and overall satisfaction score than those in group A.
Conclusion: Gum chewing provides a simple method for early recovery from post-operative ileus. Patients can tolerate gum chewing as early as the first operative day. It is a physiological method for stimulating bowel motility. Gum chewing should be added as an adjunctive treatment in post-operative care in gynecologic surgery.
Keywords: Gum chewing, bowel ileus, gynecologic surgery
Siriraj Med J 2014;66:33-38
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