Role of Chewing Gum in Enhancing Post-Operative Recovery 0f Bowel Function after Lower Segment Cesarean Section

Main Article Content

Sidra Azhar
Filza Habib
Hasina sadiq
Maria Aslam
Irum Sohail
Maryam Ahmed Qureshi
Urooj Azam
Muhammad Ali Hassan


Background: The frequency of cesarean sections globally exceeds the World Health Organization's recommended rates, leading to an increased focus on postoperative recovery, particularly the restoration of gastrointestinal (GIT) function. The delayed return of intestinal activity, known as postoperative ileus, can extend hospital stays and elevate healthcare costs. Chewing gum has been proposed as a simple, non-pharmacological intervention to stimulate the GIT and potentially expedite recovery.

Objective: This study aimed to evaluate the efficacy of chewing gum in improving GIT activity and recovery in patients following a cesarean section, contributing to the evidence base for postoperative care practices in obstetrics and gynecology.

Methods: A cross-sectional comparative analytical study was conducted at the Department of Obstetrics and Gynecology, KRL Hospital Islamabad, from May 2021 to November 2021. Two hundred patients undergoing elective cesarean sections were divided into two groups: Group A (n=100), who received chewing gum postoperatively, and Group B (n=100), who did not. The primary outcomes measured were the time to first bowel sound, time to first flatus, and time to first defecation. Data were analyzed using SPSS version 25, with a significance level set at p≤0.05.

Results: Group A demonstrated a significantly faster time to first bowel sound (3.75 ± 1.31 hours vs. 7.01 ± 1.94 hours, p=0.001), first flatus (7.97 ± 1.96 hours vs. 14.75 ± 3.57 hours, p=0.001), and first defecation (32.37 ± 3.56 hours vs. 48.20 ± 6.06 hours, p=0.001) compared to Group B. These findings were consistent across age stratifications, with significant improvements in GIT recovery times in younger (18-25 years) and older (26-35 years) subsets of patients.

Conclusion: Chewing gum post-cesarean section significantly accelerates the recovery of GIT functions, reducing the time to first bowel sound, flatus, and defecation. This study supports the inclusion of chewing gum as a low-cost, effective method in postoperative care protocols for cesarean section patients, potentially improving patient outcomes and reducing healthcare costs.

Article Details

How to Cite
Azhar, S., Habib, F., sadiq, H., Aslam, M., Sohail, I., Qureshi, M. A., Azam, U., & Hassan, M. A. (2024). Role of Chewing Gum in Enhancing Post-Operative Recovery 0f Bowel Function after Lower Segment Cesarean Section. Journal of Health and Rehabilitation Research, 4(1), 1023–1027.
Author Biographies

Sidra Azhar, KRL Hospital Islamabad Pakistan.

Ex Resident Trainee, Obstetrics and gynaecology.

Filza Habib, Mohi-ud-Din Islamic Medical College Mirpur AJK Pakistan.

Assistant Professor, Obstetrics and gynaecology.

Hasina sadiq, Shifa Tameer-e-Millat University Islamabad Paksitan.

Senior Registrar Obstetrics and gynaecology, Shifa College of Medicine.

Maria Aslam, Shifa International Hospital Islamabad Pakistan.

Senior Registrar Obstetrics and gynaecology.

Irum Sohail, KRL Hospital Islamabad Pakistan.

Professor, Obstetrics and gynaecology.


Wajid R, Huma G, Mobushar I. Role of chewing gum on early recovery of females after cesarean section. Ann King Edward Med Univ. 2015;21(4):280-5.

Huang HP, He M. Usefulness of chewing gum for recovering intestinal function after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials. Taiwan J Obstet Gynecol. 2015;54(2):116-21.

Ajuzieogu OV, Amucheazi A, Ezike HA. The efficacy of chewing gum on postoperative ileus following cesarean section in Enugu, South East Nigeria: A randomized controlled clinical trial. Niger J Clin Pract. 2014;17(6):739-42.

Zhu YP, Wang WJ, Zhang SL. Effects of gum chewing on postoperative bowel motility after cesarean section: a meta-analysis of randomized control trials. Int J Obstet Gynecol. 2014;121(3):787-92.

Ledari FM, Barat S, Delavar MA. Chewing gum has stimulatory effects on bowel function in patients undergoing cesarean section: a randomized controlled trial. Bosn J Basic Med Sci. 2012;12(4):265-8.

Sajid A, Butt A, Sajid Aq, et al. Role of chewing gum as a predictor to return of bowel activity after Cesarean section. Soc Obstet Pak. 2017;7(2):119-23.

Mansour SE, Elnegeri MA, Ibrahim AW. Chewing gum after cesarean section: its effects on regaining intestinal function. IOSR J Nurs Health Sci. 2016;5(3):75-83.

Morais EP, Riera R, Porfírio GJ, Macedo CR, Vasconcelos VS, de Souza Pedrosa A, Torloni MR. Chewing gum for enhancing early recovery of bowel function after caesarean section. Cochrane Database Syst Rev. 2016;(10):CD011562.

Kehlet H, Wilmore DW. Evidence-Based Surgical Care and the Evolution of Fast-Track Surgery. Ann Surg. 2008;248(2):189–98.

Ciardulli A, Saccone G, Di Mascio D, Caissutti C, Berghella V. Chewing gum improves postoperative recovery of gastrointestinal function after cesarean delivery: a systematic review and meta-analysis of randomized trials. J Matern Fetal Neonatal Med. 2017;30(6):1-9.

Wen Z, Shen M, Wu C, Ding J, Mei B. Chewing gum for intestinal function recovery after caesarean section: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2017;17(1):105.

Altraigey A, Ellaithy M, Atia H, Abdelrehim W, Abbas AM, Asiri M. The effect of gum chewing on the return of bowel motility after planned cesarean delivery: a randomized controlled trial. J Matern Fetal Neonatal Med. 2020 May;33(10):1670-7.

Duluklu B, Senol Celik S. Effect of Gum Chewing on Recovery After Surgery for Colorectal Surgery Patients: A Randomized Controlled Trial. Gastroenterol Nurs. 2020 Nov;43(6):422-8.

Shabaan M, Dieb A. The role of gum chewing in regaining bowel motility in patients undergoing cesarean section: a randomized controlled trial. Evid Based Women's Health J. 2019 Nov;9(4):568-73.

Gayathri R, Sagili H, Rajagopalan G, Elamurugan TP. Effect of chewing gum on bowel recovery following caesarean section: a randomized controlled trial. Int Surg J. 2020 Oct;7(11):3576-80.

Salameh JR. Ileus Prevention and Management. InLumbar Spine Access Surgery: A Comprehensive Guide to Anterior and Lateral Approaches 2024 Feb 21 (pp. 237-245). Cham: Springer International Publishing.

Ledari FM, Barat S, Delavar MA. Chewing gums has stimulatory effects on bowel function in patients undergoing cesarean section: a randomized controlled trial. Bosn J Basic Med Sci. 2012;12(4):265.

Rashad WAE-H, Suliman A, Yousef A. Effect of sugarless gum chewing on intestinal movement after cesarean section. Life Sci J. 2013;10(4):3257-61.

Cui Y, Liu M, Zhang H, Zhang X, Tang Y, Wu ZH, Li RC, Chen QX, Meng Y, Wang B, Pan HB. Effect evaluation of different preventive measures for ileus after abdominal operation: A systematic review and network meta-analysis. Heliyon. 2024 Feb 2.

Tao L, Li Y, Wang Z. The application of mirabilite in traditional Chinese medicine and its chemical constituents, processing methods, pharmacology, toxicology and clinical research. Frontiers in Pharmacology. 2024 Jan 4;14:1293097.

Most read articles by the same author(s)