Effect of Chewing Gum on Postoperative Gastrointestinal Recovery in Patients Undergoing Abdominal Surgery: A Randomized Controlled Study

Background Postoperative ileus is a common complication following abdominal surgeries, leading to delayed recovery, prolonged hospital stay, and increased patient discomfort. Chewing gum, a form of sham feeding, has been proposed as a simple, non-pharmacological intervention to stimulate gastrointestinal motility and hasten postoperative recovery. This study aimed to evaluate the effect of chewing gum on postoperative recovery of gastrointestinal function in patients undergoing abdominal surgery. Methods This single-blinded randomized controlled study included 198 adult patients undergoing elective abdominal surgeries, who were randomly allocated to a chewing gum group (n = 99) or a control group (n = 99). Patients in the intervention group received postoperative chewing gum once fully conscious with intact airway reflexes, while the control group received standard postoperative care. Primary outcomes included the time to passage of first flatus and the appearance of first bowel sound. Secondary outcomes were postoperative nausea and vomiting (PONV), length of hospital stay, and safety outcomes. Time-to-event analyses were performed using Kaplan-Meier curves with log-rank tests, and multivariable logistic regression was used to identify independent predictors of gastrointestinal recovery. Results Baseline demographic and surgical characteristics were comparable between groups. The chewing gum group demonstrated significantly earlier passage of first flatus (197.0 ± 3.6 vs 280.0 ± 6.3 minutes; p < 0.0001) and earlier appearance of first bowel sounds (201.5 ± 3.8 vs 280.0 ± 6.3 minutes; p < 0.0001). These benefits were consistent across surgical approaches and gender subgroups. The incidence and duration of PONV were significantly lower in the chewing gum group, with faster complete remission (126.0 ± 13.5 vs 237.5 ± 13.1 minutes; p < 0.0001). The hospital stay was significantly shorter in the chewing gum group (1.7 ± 1.3 vs 3.1 ± 1.7 days; p < 0.001). On multivariable analysis, chewing gum independently predicted earlier gastrointestinal recovery (OR = 0.29, 95% CI 0.15-0.59; p < 0.001). No intervention-related adverse events were observed. Conclusion Chewing gum significantly accelerates postoperative gastrointestinal recovery, reduces PONV, and shortens hospital stay following abdominal surgery. Given its safety, simplicity, and low cost, chewing gum should be considered a valuable adjunct to standard postoperative care and Enhanced Recovery After Surgery protocols.