Home Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
Article
Licensed
Unlicensed Requires Authentication

Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial

  • Magdy Refaat Ahmed EMAIL logo , Waleed Ali Sayed Ahmed , Rasha Elsayed Khamess , Manar S. Youwakim and Khaled Mohamed EL-Nahas
Published/Copyright: February 16, 2018

Abstract

Aim:

To compare the efficacy of three postoperative feeding regimens on bowel function recovery after term elective cesarean section (CS).

Methods:

Women recruited for this randomized trial were allocated into three groups. Women in group (A) were instructed to chew sugarless gum for 10 min every 2 h after surgery. Group (B) mothers received IV fluids for 6 h followed by sipping fruit juices sweetened with honey. Group (C) had oral intake of clear fluids after passage of flatus and regular diet with the passage of bowel movement. The main outcome measures were the timing of first return to bowel movement and initiation of regular diet.

Results:

The mean times to first hearing of bowel sounds, to first flatus passage and to first defecation were significantly lower in group A (10, 17.5 and 28.1 h, respectively) compared to groups B and C [15.1, 24.9 and 36 h (B) and 21.6, 38.8 and 49.4 h (C)]. Initiation of regular diet was significantly earlier in group A compared to groups B and C (21 vs. 27.5 and 40.3 h, respectively).

Conclusion:

Chewing gum appears to be more advantageous than early or traditional feeding regimens after term elective CS resulting in rapid recovery of bowel function.


Corresponding author: Dr. Magdy Refaat Ahmed, Obstetrics and Gynecology Department, Faculty of Medicine, Suez Canal University, Round Road, Ismailia 41111, Egypt, Tel.: 002663458960

Acknowledgments

We would like to thank our patients for participating in the study. We also appreciate the help of the nursing staff in the obstetrics department throughout the course of the study.

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

[1] Jakkaew B, Charoenkwan K. Effects of gum chewing on recovery of bowel function following cesarean section: a randomized controlled trial. Arch Gynecol Obstet. 2013;288:255–60.10.1007/s00404-013-2727-xSearch in Google Scholar

[2] Behm B, Stollman N. Postoperative ileus; etiologies and interventions. Clin Gastroenterol Hepatol. 2003;1:71–80.10.1053/cgh.2003.50012Search in Google Scholar

[3] Adeli M, Razmjoo N, Tara F, Ebrahimzade S. Effect of early post cesarean feeding on gastrointestinal complications. Nurs Midwifery Stud. 2013;2:176–81.10.5812/nms.10184Search in Google Scholar

[4] Konturek SJ, Thor P. Relation between duodenal alkaline secretion and motility in fasted and sham-fed dogs. Am J Physiol. 1986;251:591–6.10.1152/ajpgi.1986.251.5.G591Search in Google Scholar

[5] Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006;30:1382–91.10.1007/s00268-005-0613-9Search in Google Scholar

[6] Asao T, Kuwano H, Nakamura J, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002;195:30–2.10.1016/S1072-7515(02)01179-1Search in Google Scholar

[7] 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;54:116–21.10.1016/j.tjog.2014.10.004Search in Google Scholar PubMed

[8] Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. Int J Gynaecol Obstet. 2009;116:1334–9.10.1111/j.1471-0528.2009.02225.xSearch in Google Scholar PubMed

[9] Fleiss JL. Statistical methods for rates and proportions. New York: John Wiley and Sons; 1981.Search in Google Scholar

[10] Abd Rabbo S. Early oral hydration: a novel regimen for management after elective cesarean section. J Obstet Gynaecol. 1995;21:563–7.10.1111/j.1447-0756.1995.tb00913.xSearch in Google Scholar PubMed

[11] Keenahan M. Does gum chewing prevent postoperative paralytic ileus? Nursing. 2014;44:1–2.10.1097/01.NURSE.0000446649.56360.b8Search in Google Scholar PubMed

[12] Charoenkwan K, Palapinyo C. Early solid food after cesarean section and postoperative ileus. Int J Gynaecol Obstet. 2005;90:144–5.10.1016/j.ijgo.2005.03.009Search in Google Scholar PubMed

[13] Lee JT, Hsieh MH, Cheng PJ, Lin JR. The role of Xylitol gum chewing in restoring postoperative bowel activity after cesarean section. Biol Res Nurs. 2016;18:167–72.10.1177/1099800415592966Search in Google Scholar PubMed

[14] Adupa D, Wandabwa J, Kiondo P. A randomised controlled trial of early initiation of oral feeding after caesarean delivery in Mulago Hospital. East Afr Med J. 2003;80:345–50.10.4314/eamj.v80i7.8716Search in Google Scholar PubMed

[15] Kovavisarach E, Atthakorn M. Early versus delayed oral feeding after cesarean delivery. Int J Gynecol Obstet. 2005;90:31–4.10.1016/j.ijgo.2005.03.017Search in Google Scholar PubMed

[16] Ferraz AA, Cowles VE, Condon RE, Carilli S, Ezberci F, Frantzides CT, et al. Nonopioid analgesics shorten the duration of postoperative ileus. Am Surg. 1995;61:1079–83.Search in Google Scholar

[17] Moraca RJ, Sheldon DG, Thirlby RC. The role of epidural anesthesia and analgesia in surgical practice. Ann Surg. 2003; 238:663–73.10.1097/01.sla.0000094300.36689.adSearch in Google Scholar PubMed PubMed Central

[18] Howkins J, Hudson CN. Shaw’s textbook of operative gynecology. 4th ed. Edinburgh – London – New York: Churchill Livingstone; 1977. p. 78.Search in Google Scholar

Received: 2017-09-11
Accepted: 2018-01-18
Published Online: 2018-02-16
Published in Print: 2018-09-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Antenatal and prepregnancy care – prevention of perinatal morbidity and mortality
  4. Review article
  5. Fetal interventional procedures and surgeries: a practical approach
  6. Opinion paper
  7. Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?
  8. Research articles
  9. Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin
  10. Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities
  11. Early postnatal echocardiographic assessment of pulmonary blood flow in newborns with congenital diaphragmatic hernia
  12. Sonographic prediction of small and large for gestational age in breech-presenting fetuses
  13. Comparison of fetal weight distribution improved by paternal height by Spanish standard versus Intergrowth 21st standard
  14. Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
  15. Pregnancy outcomes among patients with recurrent pregnancy loss and chromosomal aberration (CA) without PGD
  16. Regular research articles
  17. Induction of labor in twin gestation: can we predict success?
  18. Low dose aspirin for preventing fetal growth restriction: a randomised trial
  19. Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
  20. Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
  21. Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy
  22. Fetal brain development in diabetic pregnancies and normal controls
  23. Body composition in preterm infants with intrauterine growth restriction: a cohort study
  24. Commentary
  25. Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
  26. Letters to the Editor
  27. Erroneous conclusion due to mis-calculation of data: reply to Rai SE, Sidhu AK, Krishnan RJ. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis. J Perinat Med 2017
  28. Reply to: Letter to the Editor by Stritzke A and Shah PS. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
  29. Congenital Zika syndrome in non-endemic regions
  30. Reply to: Congenital Zika syndrome in non-endemic regions: A neuroimaging pattern-based approach
Downloaded on 9.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpm-2017-0389/html
Scroll to top button