Outcome of Chewing Gum versus Intravenous Fluids in Prevention of Postoperative Ileus after Stoma Reversal

Abstract

Objective: This study compared the effectiveness of postoperative chewing gum with standard IV-fluid-based care in preventing POI after stoma reversal.

Methodology: This randomized controlled trial study was conducted in Department of General Surgery, PIMS, Islamabad from 01/03/25 to 30/09/2025 on 60 patients who were in a condition to undergo stoma reversal and randomly divided into two groups: Group A received three times of sugar-free chewing gum three days after surgery and Group B received only IV-fluid as a postoperative treatment. The time to first flatus and hospital stay were the primary outcomes. The secondary outcomes were the incidence of POI, the scores of postoperative pain, and patient satisfaction. Data was analyzed on SPSS version 27 and the p value of less than 0.05 was regarded as statistically significant.

Results: First flatus occurred before patients in the chewing-gum group (54.3 ± 7.9 hours) than in the control group (78.6 ± 10.4 hours). Group A also had shorter hospital stay (6.8 ± 1.1 days) as compared to Group B (9.1 ± 1.4 days). The chewing-gum group had less POI incidence, lower pain scores and increased satisfaction.

Conclusion: Chewing gum is a safe, inexpensive, and effective adjunct that enhances postoperative bowel recovery after stoma reversal. Incorporating it into routine postoperative care may help reduce POI and improve patient outcomes.