The Effect of Chewing Gum and Metoclopramide on Postoperative Ileus on Patients with Open Cholecystectomy

Abstract

Background: Postoperative ileus is a condition characterised by the inability to have bowel movements and difficulty in consuming food orally. It occurs as a consequence of a non-physical injury that disturbs the usual synchronised movement of the gastrointestinal tract. Surgeons widely agree that a certain level of postoperative ileus is a customary, necessary, and physiological reaction to both non-abdominal and abdominal surgical procedures.
Objective: In order to assess the efficiency of chewing gum and metoclopramide in managing postoperative ileus among patients who have undergone open cholecystectomy, a study was conducted.
Patients & methods: The present study is a prospective randomised clinical trial that was carried out at the Department of Surgery in Al-Kadhimiya Teaching Hospital, located in Baghdad, Iraq. The study was conducted over a period of two years, from June 2010 to June 2012. Ninety patient were enrolled in this study who were underwent uncomplicated open cholecystectomy for calculus cholecystitis. These patients were randomly divided into three equal groups, group A receive chewing gum, group B receive metoclopramide intravenously & group C receive nothing. The following parameters were examined every three hours after recovery from anesthesia, nausea, vomiting & bowel sounds. Also the time of passing the flatus, tolerance of oral fluid & discharging to home were noticed in this study.
Results: Showed that there was significant reduction in the number of patients who developed nausea and vomiting in both chewing gum & metoclopramide groups, Although the chewing gum group had a notable decrease in the time required for the recovery of bowel sounds and the duration of hospital stay, no more information was added.
Conclusion: The utilization of chewing gum or metoclopramide throughout the early stages of the postoperative phase. in patients with open cholecystectomy significantly reduce nausea &vomiting, while only chewing gum significantly hastens time to bowel function, ability to tolerate oral fluids & time to discharge home. Keywords: Chewing gum, metoclopramide, postoperative ileus, open cholecystectomy