Effect of Chewing Gum on Postoperative Ileus Following Surgery for Gastroduodenal Perforation: A Prospective Non-randomized Comparative Study.

Background Postoperative ileus (POI) is a common complication following emergency laparotomy for gastroduodenal perforation and is associated with delayed recovery, prolonged hospital stay, and increased postoperative morbidity. Chewing gum acts as a form of sham feeding and may stimulate gastrointestinal motility through cephalic-vagal stimulation. Although its benefits have been demonstrated in elective abdominal surgeries, evidence regarding its role in emergency perforation surgeries remains limited. Methods This prospective comparative study was conducted in the Department of General Surgery at Sri Devaraj Urs Medical College and Hospital, Kolar, between April 2025 and October 2025. Fifty patients undergoing emergency laparotomy for gastroduodenal perforation were included in the study and divided into two groups of 25 patients each using an odd-even allocation method. Patients in the intervention group received sugar-free chewing gum for 20 minutes three times daily beginning six hours after surgery until the first passage of flatus, whereas the control group received standard postoperative care alone. The primary outcome measure was time to first passage of flatus. Secondary outcomes included time to first stool, incidence of nasogastric tube reinsertion, duration of hospital stay, and postoperative complications. Results The mean time to first passage of flatus was significantly lower in the chewing gum group compared with the control group (32.6 ± 6.4 hours vs. 45.8 ± 8.1 hours, p < 0.001). Patients in the chewing gum group also demonstrated earlier passage of stool and shorter duration of hospital stay. The incidence of postoperative complications was lower in the chewing gum group, although the difference was not statistically significant. Conclusions Postoperative chewing gum therapy significantly improved recovery of bowel function following emergency laparotomy for gastroduodenal perforation. Chewing gum is a simple, safe, inexpensive, and non-pharmacological intervention that may reduce POI and enhance postoperative recovery in emergency abdominal surgeries.