Abstract
INTRODUCTION: Postoperative ileus (POI) is a common complication following abdominal surgeries, including cesarean sections (C-sections), and can significantly delay recovery. Although there is no specific treatment for POI, strategies like nasogastric suction, early feeding, intravenous fluids, and local analgesics can reduce the risk of paralytic ileus. Objectives: The objective of this study was to compare the effect of gum chewing on postoperative recovery of bowel function following C-section, specifically focusing on the time to first bowel sounds and the time to first defecation. METHODOLOGY: This comparative observational study was conducted at the Department of Obstetrics and Gynaecology, Benazir Bhutto Hospital, Rawalpindi, from 5th August 2016 to 4th February 2017. A total of 100 women, aged 18-44 years, undergoing elective C-sections were selected. Exclusion criteria included a history of drug consumption (especially opioids), peritonitis, and previous abdominal surgery. Participants were enrolled using purposive sampling, with 50 patients in the experimental group (gum chewing) and 50 in the control group (non-gum chewing). In the experimental group, patients chewed two sticks of commercially available sugar-free gum three times daily for 15-20 minutes starting immediately after surgery. Both groups were followed until discharge, and the time to first bowel sounds and first defecation were recorded. RESULTS: The mean age of patients in the experimental group was 29.52 ± 6.70 years, and in the control group, it was 29.88 ± 7.40 years. The mean gestational age was 39.63 ± 1.58 weeks. The mean time to first bowel sounds in the experimental group was 18.06 ± 5.11 hours, compared to 24.42 ± 8.33 hours in the control group (p-value = 0.0001). The mean time to first defecation in the experimental group was 31.5 ± 4.85 hours, while in the control group, it was 39.52 ± 5.61 hours (p-value = 0.0001). CONCLUSION: The study concluded that gum chewing significantly reduces the time to first bowel sounds and the time to first defecation in postoperative C-section patients, suggesting that this simple intervention accelerates recovery from postoperative ileus.