Effectiveness of Standard Nursing Care with Gum Chewing to Reduce Bowel Ileus in Post-operative Gynecologic Patients: Randomized Controlled Trials

• Main Authors: Kunyarat Chuamor, Jiraporn Thongdonjuy
• Format: Article
• Language: English
• Published: Mahidol University 2014-03-01
• Series: Siriraj Medical Journal
• Online Access: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/55293

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