Gum chewing and watching cooking shows may help with Appetite Loss After Major Abdominal Surgery

A study was conducted to systematically review the problem of appetite loss after major abdominal surgery. Appetite loss is a common problem after major abdominal surgery. Understanding of etiology and treatment options is limited.

They searched Medline, Cochrane Central Register of Controlled Trials, and Web of Science for studies describing postoperative appetite loss. Data were extracted to clarify definition, etiology, measurement, surgical influence, pharmacological, and nonpharmacological treatment. PROSPERO registration ID: CRD42021224489.

Results:

• Out of 6144 articles, we included 165 studies, 121 of which were also analyzed quantitatively.
• A total of 19.8% were randomized, controlled trials (n = 24) and 80.2% were nonrandomized studies (n = 97).
• The studies included 20,506 patients undergoing the following surgeries: esophageal (n = 33 studies), gastric (n = 48), small bowel (n = 6), colon (n = 27), rectal (n = 20), hepatobiliary (n = 6), and pancreatic (n = 13).
• Appetite was mostly measured with the Quality-of-Life Questionnaire of the European Organization for Research and Treatment of Cancer
• In a meta-analysis of 4 randomized controlled trials gum chewing reduced time to first hunger by 21.2 hours among patients who had bowel surgery.
• Other reported treatment options with positive effects on appetite but lower levels of evidence include, among others, intravenous ghrelin administration, the oral Japanese herbal medicine Rikkunshito, oral mosapride citrate, multidisciplin-ary-counseling, and watching cooking shows.
• No studies investigated the effect of well-known appetite stimulants such as cannabinoids, steroids, or megestrol acetate on surgical patients.