American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: http://www.sciepub.com/journal/ajnr Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Nursing Research. 2019, 7(6), 965-973
DOI: 10.12691/ajnr-7-6-9
Open AccessArticle

The Effect of Non-Sugared Gum Chewing With Early Ambulation versus Early Ambulation Only on Recovery of Bowel Function after Elective Cesarean Section

Wafaa Taha Ibrahim Elgzar1, and Violet Nicola Ghattas1

1Obstetric and Gynecologic Nursing, Faculty of Nursing, Damanhor University, Egypt

Pub. Date: September 28, 2019

Cite this paper:
Wafaa Taha Ibrahim Elgzar and Violet Nicola Ghattas. The Effect of Non-Sugared Gum Chewing With Early Ambulation versus Early Ambulation Only on Recovery of Bowel Function after Elective Cesarean Section. American Journal of Nursing Research. 2019; 7(6):965-973. doi: 10.12691/ajnr-7-6-9

Abstract

Background: The rate of CS is surged high in Egypt at 2014. Ileus is the most common CS complication. It may become serious enough to alter women post CS accommodation; delay wound healing and increase hospital stay. Aim: to investigate the effect of non-sugared gum chewing with early ambulation versus early ambulation only on recovery of bowel function after elective cesarean section. Research design: Randomized controlled clinical trial. Setting: Damanhour educational institution affiliated to ministry of health at Elbehira governorate Egypt. Participants: A systematic random sample of 100 woman undergoing elective cesarean section. Tools: Three tools were used for data collection: Structured Interviewing Schedule, Pre and intra-operative assessment sheet, bowel functions assessment sheet. Results: The study results shows statistically significant improvement in all bowel functions among intervention group compared to control. Where, The mean time hours to the first bowel sound (3.90±0.893 compared to 5.34±0.939), onset of gas passage (6.78±0.996 compared to 7.06±1.105), feeling of hunger time (7.98±1.134 compared to 9.40±1.212), begins oral fluids (3.98±0.775 compared to 5.78±0.996), feeding time (10.16±0.817 compared to 11.92±1.712), onset of defecation (12.180±1.240 compared to 14.48±1.403) were significantly shorter in the non-sugared gum chewing with early ambulation group than early ambulation only. Furthermore, abdominal distention and nausea are significantly higher among control group than intervention. Conclusion: Non-sugared gum chewing with early ambulation significantly enhance regain of all bowel functions post CS than early ambulation only. In addition, abdominal distention and nausea were significantly higher in non-sugared gum chewing with early ambulation group than early ambulation only. Recommendations: Non-sugared gum chewing could be added to post cesarean care protocols.

Keywords:
bowel function cesarean section non-sugared gums chewing

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: Whose risks? Whose benefits?. Am J Perinatol. 2012; 29(9): 7-18.
 
[2]  WHO. Global health observatory (GHO) data. Available at: https://www.who.int/gho/publications/world_health_statistics/2015/en/2015.9. Retrieved on: 30/8/2019.
 
[3]  Ministry of Health and Population [Egypt], El-Zanaty and Associates [Egypt], and ICF International. Egypt Demographic and Health Survey 2014. Cairo, Egypt and Rockville, Maryland, USA: Ministry of Health, Population, and ICF International. 2015.
 
[4]  Sanfilippo F, Spoletini G. Perspectives on the importance of postoperative ileus. Curr Med Res Opin. 2015; 31(4): 675-676.
 
[5]  Taşdemir N, Şenol-Çelik S. Experiences of patients toward abdominal distension after surgical intervention. Ege Üniversitesi Hemşirelik Yüksek OkuluDergisi. 2010; 26(3): 23-31.
 
[6]  Jakkaew B, Charoenkwan K. Effects of gum chewing on recovery of bowel function following cesarean section: A randomized controlled trial. Arch Gynecol Obstet. 2013; 28(8):255–260.
 
[7]  Fraser D and Cooper M. Myles’ Textbook for Midwives. 15th Ed. Elsevier: Mosby Co. 2009.
 
[8]  Ge W, Chen G, and Ding Y. Effect of chewing gum on the postoperative recovery of gastrointestinal function. Int J ClinExp Med; 8(8), 2015, 11936-11942.
 
[9]  Schuster R, Grewal N, Greaney G, Waxman K, Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg; Sigma Theta Tau International, 141(2), 2006, 174-6.
 
[10]  Ledari F, Barat S, Delavar M, Banihosini S, Khafri S. Chewing Sugar-Free Gum Reduces Ileus After Cesarean Section in Nulliparous Women: A Randomized Clinical Trial. Iran Red Crescent Med J. 2013; 15(4): 330-334.
 
[11]  Zhu Y, Wang W, Zhang S, Dai B, Ye D. Effects of gum chewing on postoperative bowel motility after cesarean section: a meta-analysis of randomized controlled trials. BJOG. 2014; 121(9): 787-792.
 
[12]  Mansour S, Elnegeri M, Ibrahim A. Chewing Gum after Cesarean Section: It's Effect on Regaining Intestinal Function. IOSR Journal of Nursing and Health Science. 2016; 5(6):75-83.
 
[13]  Bela S, Stephen C. Evaluation of gum chewing on the return of bowel function in cesarean-delivery patients. Obstet Gynecol. 2006; 107(4): 10-15.
 
[14]  Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009; 116(10): 1334-9.
 
[15]  Tandeter H. Hypothesis: hexitols in chewing gum may play a role in reducing postoperative ileus. Medical Hypotheses. 2009; 72(1): 39-40.
 
[16]  Farideh A, Pourjavad M, Atieh M, Tara F, Mohammad V. Effect of Gum Chewing on Prevention of Post Cesarean Ileus. Hayat. 2008; 14(2): 35-40.
 
[17]  Murray S, and Mckinne, E.. (2014). Foundation of maternal and newborn health nursing 6th edition. USA. Elsevier health sciences. p. 409.
 
[18]  Darvall J, von Ungern-Sternberg BS, Braat S, et al. Chewing gum to treat postoperative nausea and emesis in female patients (CHEWY): rationale and design for a multicentre randomized trial. BMJ Open 2019; 9: e027505.
 
[19]  Xu C, Peng J, Liu S and Qi D. Effect of chewing gum on gastrointestinal function after gynecological surgery: A systematic literature review and meta-analysis. Journal of obstetrics and Gynecology research. 2018; 4(5): 936-943.
 
[20]  Waldhausen J and B Schirmer B. The effect of ambulation on recovery from postoperative ileus. 212(6): 671-677.
 
[21]  Ge B, Zhao H, Lin R, Wang J, Chen Q, , Liu L, Huang Q. Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer. A randomized controlled trial. Medicine; 2017: 96 (13):1-5.
 
[22]  Mei B, Wang W, Cui F, Wen Z, Shen M. Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract.. 2017; 2017: 3087904.
 
[23]  Conor P, Zutshi M, Anthony J, Feza H, Hammel J, Victor W. Prospective, Randomized, Controlled Trial Between a Pathway of Controlled Rehabilitation With Early Ambulation and Diet and Traditional Postoperative Care After Laparotomy and Intestinal Resection. Diseases of the Colon & Rectum journal. 2003; 46(7): 851-857.
 
[24]  Jyoti V, Kshirsagar N. Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters. Journal of Krishna Institute of Medical Sciences University.2014;3(1):41-48.
 
[25]  Kumar A, Kumari R, Kumar S, Raj P. Effect of chewing gum on bowel motility in post-operative patients following abdominal surgery: a clinical outcome based study. International Surgery Journal. 2018; 5(8): 2808-2812
 
[26]  Bhatiyani B, Bhasani D, Dhumale S. Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery. Int J Reprod Contracept Obstet Gynecol 2018; 7(2): 644-647.
 
[27]  Shang H, Yang Y, Tong X, Zhang L, Fang A, Hong L. Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. American journal of perinatology. 2010; 27(05): 387-91.
 
[28]  Kafali, H., Duvan, CI., Gözdemir, E., Simavli, S., Onaran, Y., Keskin, E. (2010). Influence of gum chewing on postoperative bowel activity after cesarean section. GynecolObstet Invest. 69(2): 84-87.
 
[29]  Dehcheshmeh, D.F., Salehian, T., Gangi, F., and Beigi, M. (2011). The effect of chewing sugar free gum after elective cesarean delivery on return of bowel function in primiparous women. 4(4): 16-20.
 
[30]  Noble, E.J., Harris, R., Hosie, K.B. (2009). Thomas S, Lewis SJ. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg. 7(2): 100-105.
 
[31]  Fitzgerald, J.E., and Ahmed, I. (2009): Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg. 33(12): 2557-2566.
 
[32]  Ertas, I.E., Gungorduk, K., Ozdemir, A., Solmaz, U., Dogan, A., and Yildirim, Y. (2013). Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: a randomized controlled trial, Gynecology Oncology. 131(1), 118-122.
 
[33]  Li, S., Liu, Y., Peng, Q., Xie, L., Wang, J., and Qin, X. (2013). Chewing gum reduces postoperative ileus following abdominal surgery: a meta-analysis of 17 randomized controlled trials. J Gastroenterol Hepatol. 28(7): 1122-32.
 
[34]  Cavuşoğlu Y, Azili M, Karaman A, Aslan M, Karaman I, Erdoğan D, and Tütün O. (2009). Does gum chewing reduce postoperative ileus after intestinal resection in children? A prospective randomized controlled trial. Eur J Pediatr Surg. Jun. 19(3): 171-3.
 
[35]  Jakkaew B, and Charoenkwan K.: Effects of gum chewing on recovery of bowel function following cesarean section: a randomized controlled trial. Arch Gynecol Obstet. 2013; 288(2): 255-260.
 
[36]  Quah H, Samad A, Neathey A, Hay D, Maw A. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorectal Dis 2006; 8: 64-70.
 
[37]  Niloff PH. Does gum chewing ameliorate postoperative ileus? Results of a prospective randomized, placebo-controlled trial. J Am Coll Surg 2006; 203: 405.
 
[38]  Huang H. and He M., Usefulness of chewing gum for recovering intestinal function after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials. Taiwanese Journal of Obstetrics & Gynecology; 54(2), 2015, 116-121.
 
[39]  Kouba E, Wallen E, Pruthi R. Gum chewing stimulates bowel motility in patients undergoing radical cystectomy with urinary diversion. Urology 2007; 70: 1053-1056.
 
[40]  Lim P, Morris O, Nolan G, Moore S, Draganic B, and Smith SR, Sham feeding with chewing gum after elective colorectal resectional surgery: A randomized clinical trial. Ann Surg. 2013; 257 (6): 1016-10.
 
[41]  Zaghiyan K, Felder S, Ovsepyan G, Murrell Z, Sokol T, Moore B, and Fleshner P, A prospective randomized controlled trial of sugared chewing gum on gastrointestinal recovery after major colorectal surgery in patients managed with early enteral feeding. Dis Colon Rectum. 2013; 56(3): 328-33.
 
[42]  Forrester D, Doyle-Munoz J, Mc Tigue T, D’Andrea S, and Natale-Ryan A, The efficacy of gum chewing in reducing postoperative ileus: a multisite randomized controlled trial. J Wound Ostomy Continence Nurs. 2014; 41(3):227-232. 5.
 
[43]  Şenol T, Mesut Polat M, Özkaya E, Ünver G, Karateke A. Effect of Gum Chewing on Intestinal Functions after Gynecological Operations: A Randomized Controlled Study Gynecology Obstetrics & Reproductive Medicine 2016; 22-23.
 
[44]  Bela S and Stephen C. Evaluation of gum chewing on the return of bowel function in cesarean-delivery patients. Obstet Gynecol. 2006; 107(4):10S.
 
[45]  Griffiths P and Watson H. Chewing gum for postoperative ileus. Cochrane Database of Systematic Reviews. 2007; 2(10): 6-10.
 
[46]  Hirayama I, Suzuki M, Ide M, Asao T, Kuwano H. Gum-chewing stimulates bowel motility after surgery for colorectal cancer. Hepatogastroenterology. 2006; 53(68): 206-208.
 
[47]  Ghafouri A, Soroush A, Moini N, Hedayat A, Khorgami Z. The efficacy of sugar free gum chewing after upper GI tract operation on ileus: a clinical trial IJ Surgery. 2008; 16(1): 79-85.
 
[48]  Abdollahi A, yazdi k, Behnampur N, Neyaze M. The effect of chewing gum on bowel movements after appendectomy. Arak University of Medical Sciences Journal. 2011; 13(4): 38-43.
 
[49]  Sahin E, and Terzioglu F. The effect of gum chewing, early oral hydration, and early mobilization on intestinal motility after cesarean birth. Worldviews on Evidence-Based Nursing, 2015; 12(6), 2015, 380-8.
 
[50]  Banihosini S and Khafri S, Sugar-Free Gum Chewing Reduces Ileus after Cesarean Section in Nulliparous Women: A Randomized Clinical Trial. Iran Red Cres Med J.; 2013; 15(4): 1-15.
 
[51]  Charoenkwan K and Palapinyo C. Early solid food after cesarean section and postoperative ileus. Int. J Gynecol. Obstet. 2005; 90 (2): 144-5.
 
[52]  Safdari F, Salehian T, Gangi F and Beigi M., The Effect of Chewing Sugar Free Gum after Elective Cesarean-Delivery on Return of Bowel Function in Primiparous Women: QOM University Of Medical Sciences Journal, 4( 4), 2011, 16-20.