The Effect of Xylitol Gum Chewing After Cesarean on Bowel Functions: A Randomized Controlled Study

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Postoperative ileus after cesarean is a common complication. The delay of bowel functions after cesarean influences early parenthood experience, increases the need for analgesic use, extends the duration of hospital stay, and causes cost increase. This study aimed to explore the effect of xylitol gum chewing after cesarean on bowel functions. A prospective randomized controlled trial was conducted on subjects immediately after second hour of the cesarean in a ward of maternity. A total of 69 women were randomized to the xylitol gum chewing group (n=23), the nonxylitol gum chewing group (n=23), or the control group (n=23). Data were collected from the women who agreed to participate and met the inclusion criteria. Starting with the second hour after the cesarean, women in the xylitol and nonxylitol gum chewing group were asked to chew gum for 15 minutes every 2 hours. The practice of chewing gum minimum of 8 hours and a maximum of 12 hours continued (until midnight). The data regarding the first times for bowel sounds, flatulation, defecation, a feeling of hunger, and length of hospital stay were compared. There is no difference in starting time of first bowel sounds (P=.070) and the first feeling of hunger (P=.098) among the groups. The first flatulation started at an earlier time in the xylitol gum chewing group than the control group (17.35 ± 6.27 vs 11.18 ± 5.39 hours, P=.003); first defecation time started earlier in the xylitol gum chewing group than nonxylitol gum chewing group (44.05 ± 9.4 vs 37.58 ± 9.96 hours, P=.022). Xylitol gum chewing group (51.77 ± 10.3 vs 46.33 ± 8.11 hours, P=.028) and nonxylitol gum chewing group (51.77 ± 10.3 vs 50.23 ± 5.72 hours, P=.024) were discharged from the hospital earlier than control group. In nursing care after cesarean, early period xylitol gum chewing is an efficient and user-friendly method to prompt bowel functions earlier. Xylitol gum chewing in nursing care is suggested to be involved.