Chewing Gum Speeds Recovery of Bowel Function After Emergency Surgery for Gastroduodenal Perforation: Study
India: Chewing sugar-free gum after emergency surgery for gastroduodenal perforation may help restore bowel function sooner and shorten hospital stay, a new prospective study has revealed. Researchers found that patients who chewed gum after surgery passed gas and stool earlier than those receiving standard postoperative care alone, suggesting that this simple, low-cost intervention could help reduce postoperative ileus (POI).
The findings, published in Cureus, come from a study led by Bindu N from the Department of General Surgery, Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, India.
Postoperative ileus, a temporary slowing of bowel activity after surgery, is a common complication following emergency laparotomy for gastroduodenal perforation. It can delay recovery, prolong hospitalization, and increase postoperative morbidity. Chewing gum is considered a form of "sham feeding" that may stimulate bowel activity through cephalic-vagal pathways, but evidence supporting its use after emergency abdominal surgery has been limited.
To evaluate its effectiveness, researchers conducted a prospective comparative study between April and October 2025 involving 50 patients undergoing emergency laparotomy for gastroduodenal perforation. Participants were allocated into two groups of 25 using an odd-even method. Patients in the intervention group chewed sugar-free gum for 20 minutes three times daily, starting six hours after surgery until the first passage of flatus, while the control group received standard postoperative care. The researchers assessed time to first passage of flatus as the primary outcome, along with time to first stool, need for nasogastric tube reinsertion, length of hospital stay, and postoperative complications.
Key findings:
- Patients who chewed gum passed their first flatus significantly earlier than those receiving standard care (32.6 hours vs. 45.8 hours).
- The chewing gum group also experienced an earlier first bowel movement.
- Hospital stay was shorter among patients who received chewing gum therapy.
- Postoperative complications were less frequent in the chewing gum group, although the difference was not statistically significant.
- No major safety concerns related to chewing gum use were reported.
The researchers suggested that chewing gum may enhance gastrointestinal recovery by stimulating cephalic-vagal pathways and the release of digestive hormones, although these mechanisms were not directly evaluated.
They noted that the study was limited by its small sample size, single-center design, non-randomized odd-even allocation, lack of blinding, absence of compliance and patient-reported outcome assessments, and non-standardization of the chewing gum used.
Despite these limitations, the authors concluded that chewing gum is a simple, safe, low-cost, non-pharmacological intervention that may improve postoperative recovery and called for larger multicenter randomized controlled trials to validate the findings and develop standardized treatment protocols.
Reference:
N B, PN S, Dave P (June 10, 2026) Effect of Chewing Gum on Postoperative Ileus Following Surgery for Gastroduodenal Perforation: A Prospective Non-randomized Comparative Study. Cureus 18(6): e110577. DOI 10.7759/cureus.110577
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