Role of Gum Chewing in post-operative gut motility after Cesarean Section

Abstract

Background: Postoperative ileus is a common complication following cesarean section, resulting in delayed bowel motility, abdominal discomfort, and prolonged hospital stay. Various non-pharmacological strategies have been explored to enhance gastrointestinal recovery, among which gum chewing is gaining recognition. Acting as a form of sham feeding, gum chewing stimulates the cephalic-vagal pathway, which in turn promotes intestinal motility. However, there is limited local evidence to support its implementation in post-cesarean care.

Objective: To compare the outcomes of gum chewing versus control in promoting postoperative gut motility after cesarean section.

Methods: This randomized controlled trial was conducted over six months (May to October 2024) in the Department of Obstetrics and Gynecology at CMH Gujranwala. A total of 60 pregnant females undergoing cesarean delivery under spinal anesthesia were enrolled and randomized equally into two groups. Group A received sugar-free chewing gum 6 hours postoperatively, three times daily until the passage of first flatus. Group B received routine postoperative care. Clinical parameters recorded included time to first feeling of hunger, time to first flatus, time to first fecal passage, and duration of hospital stay. Data were entered and analyzed using SPSS version 25, and independent sample t-tests were applied. A p-value ≤0.05 was considered statistically significant.

Results: The mean time to first hunger sensation was 11.13 ± 1.87 hours in the chewing gum group and 15.33 ± 2.11 hours in the control group (p < 0.001). Time to first flatus was 12.37 ± 2.54 hours vs. 17.93 ± 1.64 hours (p < 0.001), while time to first fecal passage was 21.13 ± 2.27 hours vs. 27.67 ± 5.19 hours (p < 0.001), respectively. Mean hospital stay was significantly shorter in the chewing gum group (2.67 ± 0.61 days) compared to control (4.17 ± 1.12 days; p < 0.001).

Conclusion: Chewing gum significantly enhances postoperative gastrointestinal motility and facilitates earlier discharge following cesarean section.