Chewing gum significantly decreases postoperative constipation in TKR patients: study

Postoperative constipation significantly impacts the quality of life during the immediate postoperative period. Non-pharmacological interventions are preferred over the use of synthetic drugs. The study by Ravikumar Mukartihal et al evaluated the effect of using chewing gum over the perioperative period on improving bowel activity during the postoperative periods in patients who underwent total knee replacement (TKR).

A prospective randomized controlled trial was conducted on 252 patients who underwent TKR. Only patients having a natural defecation pattern preoperatively and not suffering from any diseases affecting bowel movements were included in the study. The patients were classified into two groups, and computer-generated numbers did the randomization. The postoperative analgesia and rehabilitation protocol were the same for both groups. The sugar-free chewing gum (for better glycemic control) was given to the study group to chew for approximately 15 min every 6th hour from shifting out of the operation theatre until the first stool was passed. For the control group, 200 mL of warm water (37 degrees) was given every 6th hour from shifting out of the operation theatre until the first stool was passed. The patients were asked whether they passed 1st flatus or 1st stool at fixed intervals.

Key findings of the study were:

• The study group (group I) consisted of 55 males and 45 females, whereas in the control group (group II) there were 57 males and 43 females.

• The first flatus was passed on the day of surgery by 71% of patients from the study group and 50% from the control group.

• The first stool was passed postoperative day 1 by 71% of patients from the study group and 20% from the control group. These differences are statistically significant.

The authors concluded – “Chewing gum significantly improved bowel activity in postoperative TKR patients and would be a safe, effective, non-pharmacological method for decreasing postoperative constipation. This would be a widely available and well-tolerated solution to ameliorate an old problem.”

Further reading:

The Effect of Chewing Gum on Improving Bowel Activity during the Postoperative Period in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial

Ravikumar Mukartihal et al

Indian Journal of Arthroplasty, Volume 1 Issue 2 (October–December 2024)