# Chewing after colon surgery helps recovery



## SpAsMaN* (May 11, 2002)

http://www.thestar.com/NASApp/cs/ContentSe...id=968332188492Chewing after colon surgery helps recovery: StudyFeb. 20, 2006. 04:29 PMCANADIAN PRESSChomping on a wad of gum may not be the most attractive habit, but a new study suggests that having a good chew may actually help patients recover more quickly from gastrointestinal surgery.U.S. researchers have found that patients prescribed gum after lower colon surgery got out of hospital on average 2 1/2 days ahead of those who weren't told to chew the popular confectionery item."It's basically a very simple concept â€" and that is that people after operations, including colon operations, have what's called ileus, a sort of paralysis of the intestines," said Dr. Kenneth Waxman, a general surgeon at Santa Barbara Cottage Hospital and principal investigator of the study."And that's why it takes a while before you can start eating again after you have abdominal surgery," Waxman said from Santa Barbara, Calif. "And in colon surgery, that can be a substantial time, frequently four or five days before the colon wakes up and starts (muscular contractions) again."One school of thought is that such patients should be fed soon after surgery to trick the intestines into working, but Waxman said many patients' stomachs can't tolerate food and reject it, and that can delay healing even longer.Instead, he came up with the idea of trying chewing gum to trigger the digestive system."The gum chewing is an idea to simulate feeding without filling the stomach up, and it's basically tricking the body into thinking that you're eating without eating and stimulating the nerve pathways to the brain and to the stomach to speed up the return of bowel function," he said.In the study, Waxman's team asked 17 patients who had undergone a lower colon operation to chew a stick of gum three times a day, beginning on the first day after surgery. Another 17 patients matched for age, sex and surgery indications were given no gum.The gum-chewing group left the hospital after an average of 4.3 days, compared with 6.8 days for the control group, said the study, published in the Journal of the American Medical Association's Archives of Surgery.Patients who chewed gum also passed gas sooner (65.4 hours versus 80.2 hours after surgery) and had their first bowel movement earlier (after 63.2 hours compared with 89.4 hours) than those who did not.While those aspects of recovery may seem like just too much information for some, Waxman said signs indicating a return of normal bowel function are important. "Medically, if you know the intestine's working, you know the operation is a success and there are no complications. And the sooner you know that the better."While conceding the study is small in numbers, Waxman said it is nevertheless "highly statistically significant."Since completion of the study about 18 months ago, doctors at the California hospital routinely prescribe gum to all their abdominal surgery patients."Number 1, they like it because it keeps their mouth from getting dry, and Number 2, it has no side-effects," said Waxman. ``There's no downside. It's cheap and it's safe."The authors suggest chowing down on gum could significantly reduce the cost of post-operative bowel dysfunction, which has been estimated to cost the U.S. health-care system $750 million US a year.Any type of abdominal surgery can cause a decrease or stoppage of intestinal function, resulting in pain, vomiting and abdominal distension, the researchers explain."The lack of bowel motility causes the patients to stay in the hospital longer, and staying in the hospital longer isn't healthy for you," said Waxman, noting that patients are at risk for hospital-borne infections and other complications."So it's more expensive, it's more uncomfortable, it's away from their home and their work, so there's a lot of advantages to being able to eat and leave the hospital earlier."


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