Abstract
Background: Post- operative gastrointestinal dysfunction is one of the complications following abdominal surgery which results in delayed return of bowel motility. It causes discomfort, prolonged hospital stay; hospital acquired infection and enhanced treatment cost. This study was conducted with an aim to analyze the clinical outcome of effect of chewing gum mainly to avoid post-operative gastrointestinal dysfunction and to compare the different gastrointestinal variables between cases and control group.
 Methods: In this study 80 patients were included, 40 Cases and 40. The cases were given chewing gum for duration of 15 minutes at 2nd , 4th and 6thhour of surgery. Bowel sound was auscultated at 3rd, 5th and 7th hour of surgery and outcomes were compared with control group. Control group were given only standard post-operative care.
 Results: Among cases Mean duration of 1st bowel sound appeared was 9.23±2.2 hours whie among control group was 15.99±3.48 hours and with operating time <1 hour is 5.1 ± 1.04 hours in cases and 6.2 ± .66 hours in control group while with operating time >1 hour it was 5.2 ± 1.03 hours cases and 6.3 ± 0.7 hours in control group. Mean duration of 1st flatus passed among cases was 13.3±2.24 hours while among control group was 26.62 ±2.6 hours and with operating time <1 hour was 13.8 ± 1.03 hours in cases and 16.25 ± 1.5 hours in control group, while it was 13.12 ± 1.96 hours in cases and 17.12 ± 1.5 hours in control group with operating time >1 hour. Mean duration of 1st motion passed among cases was 31.33±2.24 hours and was 44.62± 2.6 hours in control group and it was 48.8 ± 1.2 hours in cases and 50.7 ± 1.27 hours in control group with operating time <1 hour, while it was 48.8 ± 1.2 hours in cases and 51.1 ± 1.46 hours in control group with operating time >1 hour. Result was statistically significant P value (0.001).
Highlights
Gastrointestinal tract dysfunction is the most common complication that occur after abdominal surgeries and associated with higher risk of post-operative paralytic ileus (POI) 1,2,3
Particular attention has been given to early feeding regimes i.e., Sham Feeding regimes which is being investigated as a means to stimulate bowel motility and confer an advantage while minimising harm caused by early oral feeding especially in patients who do not tolerate the same
Early return of bowel gut motility leads to early starting of oral feeding, early breast feeding following caesarean section, early ambulation and early discharge from the hospital and decreases overall cost of hospitalization
Summary
Gastrointestinal tract dysfunction is the most common complication that occur after abdominal surgeries and associated with higher risk of post-operative paralytic ileus (POI) 1,2,3. POI refers to severe constipation and intolerance of oral intake resulting from a non-mechanical insult that disrupts the normal coordinated propulsive motor activity of the gastrointestinal tract, it is an iatrogenic condition that occurs following abdominal surgery especially in the presence of factors like prolonged operative time, excessive bowel manipulation, immobilization, emergency procedures. Initiation of intestinal motility after abdominal surgery is highlighted in the “Enhanced Recovery After Surgery” ERAS Protocol, known as the multidisciplinary approach[20-21] In this protocol, particular attention has been given to early feeding regimes i.e., Sham Feeding regimes which is being investigated as a means to stimulate bowel motility and confer an advantage while minimising harm caused by early oral feeding especially in patients who do not tolerate the same.
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