A Randomized Control Study On The Use Of Chewing Gum Versus Standard Post-Operative Care Following Caesarean Delivery For Early Recovery Of Bowel Activity

Abstract

Childbirth is the most stressful, exhilarating and fulfilling moment in a mother’s life. Each labour experience is unique and calls for a celebration. The delivery procedure is addressed as vaginal delivery and caesarean sections. Caesarean sections (CS) can be planned or done in an emergency. Caesarean sections generally have increased maternal surgical risks for the current and subsequent pregnancies compared to spontaneous vaginal delivery. The restoration of gut motility after surgery may be one of the postoperative problems.

Early oral intake, early mobilization, and a postoperative feeling of well-being are all aided by the early restoration of bowel motility. Generally following an abdominal surgery small intestine activity returns to normal function in few hours, gastric activity returns in 24-48hrs and colon activity will return by 48-72 hours1.

Some degree of adynamic ileus follows every laparotomy and also follows after caesarean deliveries. Postoperative ileus (POI) is primarily caused by a complex pathophysiology that is not fully understood. It can result in considerable patient morbidity and is frequently a reason for consulting gastroenterologists. POI is generally described as a temporary reduction in normal gastrointestinal movement following surgery, typically lasting 3-5 days. It is marked by symptoms such as abdominal swelling, absence of bowel sounds, and no passage of gas or stool. Factors exacerbating POI include postoperative pain, nausea, vomiting, delayed resumption of oral intake, and extended hospital stays. The overall incidence of POI for all operative procedures in the abdomen is 9.2%2.

For prevention, surgical goal strives to minimize bowel manipulation, avoid excess IV fluids or profound hypovolemia and limit surgery length. After surgery gum chewing enhanced early bowel function recovery. Chewing gum has recently become recognized as a novel, convenient, easily accessible, and of less cost to reduce postoperative ileus (POI). It works by stimulating intestinal movement through the cephalic-vagal reflex and by enhancing gastrointestinal hormone secretion responsible for bowel motility. This leads to the early restoration of bowel sounds, the passage of gas, and the return of appetite3. Therefore, we have undertaken the study to assess the effectiveness of chewing gum in promoting bowel motility following caesarean delivery.