Effect of Gum-Chewing on Peristaltic Movement of the Gasterointestinal System after Laparatomic Appendectomy- a Randomized Clinical Trial

Introduction & Ileus is one of the common complications in hospitalized patients as well as it is the most common reason of delay in discharge from the hospital due to abdominal surgeries. Present study with aim of investigating the results of chewing gum on bowel movements of digestive system after appendectomy was designed.
In this clinical trial using the related sample size formula 40 patients’ means that underwent appendectomy surgery in Besat- Hamedan Medical Center were randomly classified into the intervention and control groups (20 people per group). Inclusion criteria for the study included the age of over 15 and having appendectomy surgery and the exclusion criteria included hypothyroidism, hypo-parathyroid glands, electrolyte disorders, neuro muscular diseases and drug addiction. Method of anesthesia was similar in both groups. For the case group the chewing gum manufactured by the same factory and in the same flavor was prescribed within the four, ten and eighteen hours after the patient's recovery. No treatment was applied to the control group. One hour after the patient’s recovery and stabilization of the vital signs, the bowel sounds were examined by stethoscope by researcher in the case and control groups every two hours. The researcher evaluated flatulence and defecation by asking the patients. The collected data were analyzed by SPSS version 17 and the descriptive statistics were used in the required cases and the t-test was used for the evaluation of significance of the data. The significance level of data is considered lower than 0.05.
The average time to hear the first bowel sound in experimental group was 3.30 ± 1.17 hours and in control group it was 2.60 ± 1.23 hours. Therefore there was no significant difference (P = 0.073) between the experimental and control groups. The average time to gas-passing in experimental group was10.90 ± 3.52 hours and in control group it was 17.50 ± 9.90 hours that showed a significant difference (P = 0.008) between the experimental and control groups. Average time to defecation in the experimental group was 25.40 ± 5.03 hours and in control group it was 37.70 ± 13.98 hours. Therefore there was a significant difference (P = 0.001) between the experimental and control groups. The average time to receive oral feeding in the experimental group was 17.75 ± 4.88 hours and in control group it was 18.50 ± 5.18 hours (P = 0.641). The average time to leaving the sickbed in the experimental group was 8.85 ± 5.60 hours and in control group it was 10.55 ± 4.29 hours (P = 0.28).
According to the results of this study, the average time to gas-passing and defecation in gum recipients group was significantly less than the control group. Complementary studies and finding ways to find out the chewing gum effects on reduction of Ileus time without questioning the patient about the first gas-passing and defecation after surgery was recommended.