Chewing gum hastens bowel motility and shortens hospital stay after colorectal surgery

Clinical Question

Does chewing gum hasten recovery and shorten hospital stay after colorectal surgery?

Bottom Line

Postoperative gum chewing appears to significantly reduce the length of hospital stay after colorectal surgery by 2 days to 3 days. (LOE = 1a-)


Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal surgery. A systematic review. Dis Colon Rectum 2007:50(12):2149-2157.  [PMID:17710495]

Study Design

Meta-analysis (randomized controlled trials)


Unknown/not stated


Various (meta-analysis)


Postoperative ileus frequently delays hospital discharge after colorectal surgery. These investigators thoroughly searched multiple databases including MEDLINE, EMBASE, and the Cochrane Registry of Controlled Trials, as well as manual reviews of reference lists and meeting abstracts for controlled trials comparing the addition of daily gum chewing to standard postoperative management after colorectal surgery. Only trials from the English language were included. Two independent reviewers assessed individual trials for methodological quality using standardized scoring systems. Disagreements were resolved by consensus. A total of 5 randomized controlled trials (n = 158) met eligibility criteria. Three trials had quality scores classifying them as good or better. All patients received commercially available sugarless gum 3 times daily beginning on the first postoperative day until passage of first flatus. Hospital stay was significantly shorter in the adjunct gum chewing group than in the control group (mean difference = -2.4 days). There were no differences between the 2 groups in complication, readmission, or reoperative rates. An analysis for publication bias did suggest the possibility of the search having missed some trials with negative results. Statistical results were generally homogenous, meaning that outcomes in the individual trials were similar.