Chewing gum promotes bowel function recovery in elderly patients after lumbar spinal surgery: a retrospective single-center cohort study

Background: Postoperative paralytic ileus is not a rare complication after lumbar spinal surgery especially in elderly patients. Chewing is a kind of sham feeding that has been reported to stimulate bowel motility, but so far there was no study showed these positive results may or may not be extrapolated to the spinal surgery population. We sought to determine whether chewing gum facilitates bowel function recovery in elderly patients undergoing lumbar spine surgery. Methods: Sixty consecutive elderly patients (over 60 years old) with lumbar degenerative diseases undergoing posterior lumbar fusion surgery between September 2017 and April 2019 were respectively included and divided into two groups. The chewing gum group (30 patients) started chewing gum after they were awakened from anesthesia until the first defecation occurred, while the control group (30 patients) chewed nothing. The time to first flatus, first bowel sounds heard and first defecation, the length of hospital stay and postoperative complications were all recorded and analyzed. Results: Compared with control group, the chewing gum group had less time to the first flatus (12.4 +/- 2.9 vs. 17.8 +/- 2.2 h; P<0.001), first bowel sounds heard (17.3 +/- 2.8 vs. 25.0 +/- 2.5 h; P<0.001) and first defecation (51.9 +/- 5.2 vs. 76.1 +/- 3.8 h; P<0.001), but no significant differences were found in the length of hospital stay (11.7 +/- 2.1 vs. 11.9 +/- 2.5 d; P=0.697) and the postoperative complications (P=0.501). Conclusions: This study demonstrated that chewing gum can promote bowel function recovery in elderly patients after lumbar spinal surgery.