Chewing gum significantly decreases postoperative constipation in TKR patients: study

Written by Dr Supreeth D R Published On 2025-05-09T20:00:27+05:30 | Updated On 9 May 2025 8:00 PM IST

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.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.