Study of different types of gum in induction of earlier gastrointestinal recovery after elective cesarean section: A randomized controlled trial

Background: Cesarean section (CS) is a crucial surgical technique that is done when vaginal birth have preidentified or emergent danger for both mother and baby. After any abdominal procedures, including CS, digestive functions are adversely compromised. Post-surgical autonomic nervous system change leads to disruption in intestinal activities, notably, motility. Ileus is characterized as a 3 to 5-day delay in the regular bowel motions of individuals. It is one of the most frequent post-surgeries which prolong the length of hospitalization, postoperative discomfort, stomach distension, difficulty to eat after the operation or to start breastfeeding and eventually to postpone the healing period. Chewing gum stimulates the stomach, gastric secretion and digestive materials, because of which the individual will be able to consume and there will be more peristaltic movements in their digestive system. Therefore, gum-chewing appears to successfully expedite patients’ recovery from ileus. The research is aiming to examine the impact of chewing various kinds of gum on GIT motility recovery time in women after elective cesarean birth. Methods: This is Randomized controlled experiment, was conducted out at department of obstetrics and gynecology at Benha University Hospital on 625 women split into 5 groups: (Group A-control group-) (n=125): Kept on intravenous fluids for 24 h, (Group B) (n=125): received oral fluids 6 h postoperatively, (Group C) (n=125): received sugarless gum, (Group D) (n=125): will get peppermint gum, (Group E) (n=125): received cinnamon gum. Results: There was no statistically significant difference detected between the analyzed groups for demographic data and features of the studied patients. there was no statistically significant difference detected between the study groups for Miscarriage, Surgical history, prior CD and indication of CD. There was statistically significant reduction in the operational time in group B than group A, C, D and E. Also the table reveals that there was no statistically significant difference between the five examined groups regarding pethidine requirement. There was no statistically significant difference identified between group D and E regarding audible bowel sound although there was statistically significant difference observed between both groups and the other three groups. Also the data reveals that there was statistically significant difference between group A and B and also between B and C regarding audible bowel sound. there was statistically significant difference between the Group A,B,C and D however there was no statistical significant difference between Group D and E related time to first pass flatus. there was statistically significant difference between the Group A,B,C and D however there was no statistical significant difference between Group D and E related time to first pass feaces. There was statistically significant difference between the Group A and B but there was no statistical significant difference between Group C, D and E for parentral fluid volume and IV fluid time. there was statistically significant difference between group A,B and group C,D and E regarding incidence of vomiting. There was statistically significant difference between group A and group B, C and also between group A,B,C and D,E regarding incidence of abdominal distension. There was statistically significant difference between group A and B and between group A,B and the other 3 groups regarding incidence of postoperative ileus. There was statistically significant difference between the all analyzed groups except between group D and E regarding the length of hospital stay. There was statistically significant increase in the time to hungry sensation in group A and B than group C, D and E with p-value <0.001. There was statistically significant increase in the time until audible bowel sound (hours) in group A and B than group C and also in group C than group D and E with p-value <0.001. There was statistically significant increase in the time to first to pass flatus between group A, B than the other 3 groups and in group c than group D and E with p-value <0.001. Conclusion: Our study has further supported that gum chewing is associated with early recovery of intestinal function after caesarean section, which may be helpful to reduce the time to first passage of flatus, first defecation, first bowel sound, and first bowel movement and shorten the length of hospital stay. Xylitol containing gum is more effective on recovery of intestinal function than sugarless gum and there is no difference of various tastes of xylitol gum on recovery of intestinal functions.