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.