OBJECTIVE: To evaluate effects of gum-chewing on duration of ileus after cesarean section and differences in effects of sugar-free gum and sugar-substituted gum.

MATERIALS AND METHODS: Seventy-six women with no prior abdominal or cesarean surgery were consecutively allocated after elective cesarean section under general anesthesia to a) control (no-gum) group, b) sugar-free gum group, or c) sugar-substituted gum group (gum containing xylitol, sorbitol, and aspartame). Beginning 2 hours postoperatively, gum-chewing patients chewed gum for 15 minutes every 2 hours. Times to first bowel sounds, flatus, and defecation were recorded, and means ± SD compared.

RESULTS: Statistically significant decrease in time to first bowel sounds in sugar-substituted gum group (6.3 ± 2.0 h) compared to sugar-free gum group (8.8 ± 1.9 h, p < 0.05). Sugar-substituted group had significantly lower time to first bowel sounds than controls (11.2 ± 1.0 h, p < 0.05). No significant difference was noted among groups in times to first flatus or defecation.

CONCLUSION: In gum-chewing patients without prior abdominal operation who had cesarean under general anesthesia, no difference occurred in timing of first flatus or defecation. Given the previously demonstrated effectiveness of gum-chewing in ileus resolution after laparoscopic colon surgery, gum trials under epidural anesthesia or with medicated gums are warranted.