Effect of Chewing Gum on Post Cesarean Ileus in the North East of Iran: A Randomized Clinical Trial

Background & aim: Cesarean section (CS) accounts for 35% of all surgical operations in Iran. Post cesarean ileus is a complication of CS. There are various pharmaceutical and non-pharmaceutical ways for the treatment of this condition. Given the fact that the non-pharmaceutical approaches are better tolerated and often inexpensive, the present study was conducted to evaluate the effect of chewing gum on post cesarean ileus. Methods: This clinical trial was conducted on 93 patients undergoing CS (i.e., elective or urgent CS) at Sabzevar Mobini Hospital, Savzevar, Iran, between July 2013 and September 2014. The study population was selected using convenience sampling technique and assigned into two groups of chewing gum (n=35) and control (n=58) groups. The subjects in the chewing gum group were encouraged to chew gum at defined intervals. Both groups were evaluated for pain, bowel sounds, first defecations, gas passage, and feeling bowel movements. Data analysis was performed in SPSS software, version 21. Results: There was no significant difference between the two groups in terms of the auscultation of first bowel sound, first record of gas passing, and first defecation. The logistic regression models showed that chewing gum was significantly associated with reduced post-operative pain while controlling for surgery duration as a confounding factor (OR: 0.79, 95% CI for OR=0.63, 0.99). However, chewing gum showed no significant relationship with bowel sounds, first defecations, gas passage, and feeling bowel movements. Conclusion: As the findings indicated, the use of chewing gum after CS was ineffective in the reduction of ileus. However, this practice was only capable of mitigating post-operative pain, and therefore can be used as an adjuvant technique for the management of post-operative pain