Chewing Gum for Postoperative Ileus

(GUM_1 Trial)

Overseen By Anna Shawyer, MD, MSc

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Manitoba

Disqualifiers: Under 4, GI dysmotility, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: Up to 30 days

140 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether chewing gum can help children recover faster after abdominal surgery by stimulating bowel movement. Chewing gum may trick the stomach, speeding up recovery so children can eat solid food and return home sooner. The trial compares children who chew gum with those who do not, alongside usual care. Suitable participants are children who have undergone abdominal surgery and are hospitalized for more than a day. As an unphased trial, this study offers a unique opportunity for children to potentially experience faster recovery and contribute to innovative research.

What prior data suggests that gum chewing is safe for enhancing bowel recovery in children?

Research has shown that chewing gum after surgery is safe. Studies have found it poses very little risk to patients and is generally well-accepted. Chewing gum may aid recovery by stimulating bowel function sooner, potentially leading to a quicker return to normal eating and a shorter hospital stay. Overall, chewing gum is a safe option for post-surgery recovery. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard treatments for postoperative ileus, which often include medications to manage pain and promote bowel movement, gum chewing offers a simple, non-pharmacological approach. Researchers are excited about this technique because it leverages the body's natural reflexes: chewing gum stimulates the digestive system by mimicking the act of eating, which can help jumpstart bowel activity after surgery. This method is not only potentially effective but also avoids the side effects associated with medication. Plus, it's easy to implement and could enhance recovery while reducing the need for additional drugs.

What evidence suggests that gum chewing is effective for postoperative ileus?

Research has shown that chewing gum can help the bowels start working sooner after surgery, reducing recovery time. In this trial, participants in the gum-chewing group will receive standard pharmacologic treatment and post-operative care, along with chewing one piece of sugarless gum three times daily for 1 hour each. Some studies suggest that gum chewers may leave the hospital sooner. For instance, one study found that 27% of gum chewers experienced delayed bowel recovery, compared to 48% of those who didn't chew gum. However, not all studies agree, and some found little effect, especially in surgeries like colectomies. Overall, chewing gum is safe and might help speed up recovery by getting the bowels moving again after surgery. ^{1 6 7 8 9}

Who Is on the Research Team?

Anna Shawyer, MD, MSc

Principal Investigator

University of Manitoba

Are You a Good Fit for This Trial?

This trial is for children aged 4 or older who are undergoing abdominal surgery and expected to stay in the hospital for over 24 hours. It's not suitable for kids under 4, those unable to chew gum/swallow due to medical conditions, or if they/their parents can't consent or follow instructions.

Inclusion Criteria

My child has had abdominal surgery, either laparoscopic or open.

My child is expected to stay in the hospital for more than a day after surgery.

My child is 4 years old or older.

Exclusion Criteria

I or my parents are not willing to sign the consent form.

My child cannot chew gum or swallow due to a condition.

My child has a disorder that affects how their intestines move food.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants undergo abdominal surgery and receive usual post-operative care. In the experimental group, participants chew sugarless gum three times daily for 1 hour each.

Up to 30 days

Daily visits by surgical team

Follow-up

Participants are monitored for safety and effectiveness, including bowel recovery and any adverse reactions to gum chewing.

30 days

What Are the Treatments Tested in This Trial?

Interventions

• Gum chewing

Trial Overview The study tests whether chewing gum after abdominal surgery helps children recover bowel function faster so they can eat solid foods sooner. The idea is that 'sham feeding' with gum might speed up this recovery process.

How Is the Trial Designed?

Group I: Gum chewing Experimental Treatment 1 Intervention

Usual pharmacologic treatment and post-operative care (e.g. daily visits by surgical team, antibiotics where appropriate, mobilization, advancement of diet as tolerated). Analgesia and anti-emetics will be provided (both oral and intravenous) as needed. Intervention: 1 piece of sugarless gum to be chewed three times daily for 1 hour each.

Group II: No gum chewing Active Control 1 Intervention

Usual pharmacologic treatment and post-operative care (e.g. daily visits by surgical team, antibiotics where appropriate, mobilization, advancement of diet as tolerated). Analgesia and anti-emetics will be provided (both oral and intravenous) as needed.

Who Is Running the Clinical Trial?

University of Manitoba

Lead Sponsor

Trials

628

Recruited

209,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9912851/

Effect of Chewing Gum on Duration of Postoperative Ileus ... Chewing gum has been shown to reduce duration of ileus in many elective surgeries, but there is a paucity of randomised controlled trials (RCTs) on its effect ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12102907/

The effect of chewing gum on postoperative ileus after ... The results of this trial demonstrate that chewing gum is effective in reducing the duration of postoperative ileus and length of hospital stay ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S1072751506001268#!

Does Gum Chewing Ameliorate Postoperative Ileus? ... In contrast to findings of a preliminary study, our clinical trial suggests that gum chewing, although safe, does not reduce duration of postcolectomy ileus.

4. frontiersin.org frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1059924/full

The impact of gum-chewing on postoperative ileus ... Dutch researchers found that 27% of participants in the gum-chewing group developed postoperative ileus after surgery, compared to 48% of ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT01583452

Chewing Gum Use to Reduce Post-operative Ileus in ... The current clinical trial has as primary objective to prove the efficacy of chewing gum as a preventive measure of post-operative ileus in pediatric patients ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S1091255X23018486

The Impact of Sham Feeding with Chewing Gum on ... The use of chewing gum after colorectal surgery is a safe and effective intervention in reducing the incidence of POI and merits routine use.

7. journals.lww.com journals.lww.com/international-journal-of-surgery/fulltext/2025/05000/effect_of_chewing_gum_on_clinical_outcomes_and.30.aspx

Effect of chewing gum on clinical outcomes and... ... Chewing gum may significantly aid postoperative care by reducing time to first flatus, time to first bowel movement, and length of stay.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9887172/

The impact of gum-chewing on postoperative ileus following ... 3.3.​​ The results showed that the gum-chewing group had a significantly lower incidence of postoperative ileus, with an RR of 0.46 (95% CI: 0.30 ...

9. sciencedirect.com sciencedirect.com/science/article/pii/S1743919115000163

Chewing gum and postoperative ileus in adults Chewing gum is a safe and well tolerated method to reduce time to improve POI. · The degree of improvement is small and of limited clinical significance. · The ...