Influence of gum chewing on return of gastrointestinal function after gastric abdominal surgery in children

Purpose: The study was designed to investigate the influence of gum chewing on the return of gastrointestinal function after gastric abdominal surgery in children and the action of neural and humoral hormones in the mechanism of gum chewing. Material and Methods: Eighteen patients were enrolled in our study. Each patient underwent gastrointestinal surgery and was then randomly assigned to either the gum-chewing or the control group. The patients in the gum-chewing group chewed gum three times a day in the morning, the afternoon and the evening from the first postoperative morning until the day they began oral intake. The time of first passage of flatus was recorded to evaluate the return of bowel movement. Blood samples were taken immediately after the 3rd gum chewing for the analysis of gastrin and catecholamines (epinephrine, norepinephrine). Results: The first passage of flatus in the gum-chewing group was seen on average of 69 h after operation, which was significantly earlier than the average of 77 h in the control group (p < 0.05). However, in contrast to the time of first flatus, the values of blood catecholamines and gastrin showed no significant difference between the two groups. Conclusions: Gum chewing hastens the return of intestinal function after gastric abdominal surgery in children. The mechanism by which gum chewing initiates an earlier return of gastrointestinal function is still unknown, although neural and humoral hormones are presumed to be mediators in stimulating bowel motility.