From Our 2008 Archives

Chew Gum for Colon Surgery Recovery

Researchers Say Gum Chewing Speeds Recovery From Surgery and Cuts Health Care Spending

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

Aug. 18, 2008 — Simply chewing gum after colon surgery can reduce recovery time and shorten hospital stays, a review of research shows.

It could also save more than $100 million in health care spending annually, according to findings from one study.

In the U.S. alone, postoperative ileus — the medical term for the inability of the bowels to function normally following surgery — has been estimated to cost the health care system up to $1 billion each year.

"Postoperative ileus remains the single greatest barrier to [hospital] discharge in otherwise uncomplicated colorectal surgery," colorectal surgeon Joshua Katz, MD, tells WebMD. "If this relatively easy, safe and cheap intervention can help, it is certainly something worth trying."

Gum Chewing May Speed Recovery

The newly published analysis included five studies reported since July 2006 involving a total of 158 patients.

Gum chewing was found to speed up the time it took the intestines to begin working again after surgical removal of all or part of the colon.

In each of the studies, some patients chewed no gum and others chewed sugarless gum three times a day after surgery for five to 45 minutes.

When the all study results were analyzed together, the patients who didn't chew gum were found to have taken an average of two-thirds of a day longer to pass gas and just over one day longer than the chewers to have a bowel movement — both signs of intestinal recovery.

In the four studies that assessed length of hospital stay, the gum chewers were discharged, on average, about a day earlier, although this was not statistically significant.

Researcher Sanjay Purkayastha, BSc and colleagues from St. Mary's Hospital in London, hypothesize that gum chewing stimulates bowel recovery in the same way that eating does, by triggering the release of gastrointestinal hormones and increasing the production of saliva and secretions from the pancreas.

Their analysis appears in the August issue of Archives of Surgery.

"We feel that the current evidence suggests that gum chewing following abdominal surgery offers significant benefits in reducing the time to resolution of ileus; however, the studies are insufficiently powered to identify a significant benefit in length of [hospital] stay."

Colon Surgery and Hospital Stays

The researchers call for larger, randomized studies designed specifically to show that postsurgical gum chewing reduces hospital stays following abdominal surgery.

In a 2006 study, which was included in the analysis, researchers from Santa Barbara Cottage Hospital estimated that adding postsurgical gum chewing to the colon surgery regimen could save $118 million a year in the U.S.

In this small study, involving 17 patients who chewed gum and 17 others who didn't, the average hospital stay was 4.3 days for gum chewers — 2.5 days less than for the patients who did not chew gum.

Katz tells WebMD that the typical length of a hospital stay is around five days following colon surgery. The director of colorectal surgery for Montgomery Surgery Center in Rockville, Md., Katz says gum chewing may have a slight impact on this, but not a huge one.

"This doesn't mean that if you give someone chewing gum they will just jump out of bed and feel good enough to go home," he says. "This is major surgery."

But the surgery has also changed drastically over the last decade, and those changes have resulted in average hospital stays that are half as long as they once were, he says.

"Chewing gum is just one piece of the puzzle," he says.

SOURCES: Purkayastha, S. Archives of Surgery, August 2008; vol 143: pp 788-793. Moss, G. Surgery, 1986; vol 99: pp 206-214. Joshua A. Katz, MD, director, Montgomery Colorectal Surgery, Rockville, Md.; director, Biophysiology Center, Shady Grove Adventist Hospital, Rockville, Md. Schuster, R. Archives of Surgery, February 2006; vol 141: pp 174-176.

©2008 WebMD, LLC. All Rights Reserved.