Question

physiological and psychological measurement tools on study on reducing postoperative ileus with chewing gum.

Answer 1

Gum-chewing has found to be a form of sham feeding to stimulate bowel recovery after surgery. The presumed mechanism of action is vagal cholinergic (parasympathetic) stimulation of the gastrointestinal tract, similar to oral intake but with theoretically less risk of vomiting and aspiration. Gum-chewing immediately after surgery is a cheap and harmless strategy for reducing postoperative ileus, and it might make the patient more comfortable.

Study selection:

Studies conducted in non-surgical settings. Mostly with children. Study design was limited to randomised controlled trials (RCTs).

Chewing gum regime and patient tolerance Study:

Studies utilised commercially available sugar free gum also with sugared gum. Patients made to chew gum different time intervals. Results recorded.

Data extraction

Data extraction was carried out using predefined electronic templates. The primary outcome was whether chewing gum would result in a decrease in post operative ileus (POI) compared to control. There were no limits as to how POI was assessed. The chewing gum regime received by participants in the intervention arm of each study was recorded.

Statistical analysis

Meta-analysis was performed, the meta-analysis were assessed using mean difference (MD) or risk ratio (RR) for continuous and dichotomous outcomes respectively with 95% confidence intervals derived from a fixed effects model. The inverse variance method was used for continuous outcomes and the Mantel-Haenzsel method for dichotomous out-comes. Medians were converted to means using the method described by Hozo et al. Forest plots were constructed withr esults considered statistically significant when p < 0.05. Statistical heterogeneity was evaluated using the I2 statistic and a c2 test for heterogeneity was performed with results considered statistically significant when p < 0.10. Funnel plots were used to screen for publication bias.