Gum gives colon patients something to chew on By Kate Holloway, USA TODAY
Thu Dec 15, 7:40 AM ET
Cheryl Ankrom had set aside a minimum of one week for hospital recovery after her colon resection last August.
Thanks to chewing gum, though, she headed home after four days.
"My intestines started working almost immediately," says Ankrom, 46, of Butler, Pa., who has had other operations for conditions associated with Crohn's disease, an inflammatory gastrointestinal tract disorder. "(The doctors) were rather amazed."
In August 2004, Ankrom was among the first patients at Pittsburgh's Western Pennsylvania Hospital to participate in a study of the effects of chewing gum after laparoscopic or traditional open colon surgery. It found that for patients who had the laparoscopic procedure, chewing gum prevented postoperative ileus, in which the digestive system sleeps for some time after surgery, resulting in a longer hospital stay.
"Our theory was that if we could somehow stimulate the digestive system to 'wake up' a little bit sooner, we could get them out of the hospital a little bit sooner," says surgeon Jim McCormick of West Penn, one of three participating hospitals in Pennsylvania and Texas.
Modeled from a smaller study in Japan, the research involved 102 patients who had one of the two types of elective colon surgery. Patients were placed randomly into two groups. The control group received only the standard clear liquids at meals; the other group also was given gum.
"I think I chewed it for like a half-hour at each meal," Ankrom says.
Though there are different theories about why chewing gum works, the most prominent is that of "sham feeding," in which chewing and swallowing mimic the process of eating. That stimulates the nerves and hormones involved in moving food through the digestive tract.
The results of the study, which were presented in the fall at the annual meeting of the American College of Surgeons in San Francisco, showed that among laparoscopic patients, postoperative gum-chewing decreased hospital stays by an average of nearly one day.
The results did not show such a benefit for most open surgery patients, though it did for Ankrom. McCormick says the effect of chewing gum on non-laparoscopic patients might have been misrepresented because 95% of elective colon surgeries in his practice are performed laparoscopically.
But there may be other factors that account for the differences, he says. "The reason people get the ileus after the laparoscopic surgery may be different than the reason they get it after open surgery," he says. More tissue is manipulated in open surgery, and pain medication might contribute to postoperative ileus among open surgery patients.
Harry Papaconstantinou, a surgeon at the participating University of Texas Southwestern Medical Center in Dallas, says most patients have embraced gum-chewing. "I think it's fantastic," he says. "If we can spend as little as a dollar to try to get patients out a full day sooner, that saves about $500 for the one extra hospital day."
For Ankrom, a big gum chewer in the first place, it was perfect.
"It sounds very interesting, and there was no pain associated with it," Ankrom says. "I said, 'Sure, I'd be glad to help science out.' "