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Randomized Controlled Trial
. 2025 Dec:79:103039.
doi: 10.1016/j.ejon.2025.103039. Epub 2025 Nov 7.

Effect of gum chewing on the return of bowel sounds, time to first flatus, and defecation after colorectal cancer surgery: A prospective, randomized controlled trial

Affiliations
Randomized Controlled Trial

Effect of gum chewing on the return of bowel sounds, time to first flatus, and defecation after colorectal cancer surgery: A prospective, randomized controlled trial

Derya Gezer et al. Eur J Oncol Nurs. 2025 Dec.

Abstract

Purpose: The aim of this study was to evaluate the effectiveness of chewing gum in reducing the time taken for bowel sounds to return, the time taken for the first passage of flatus and defecation, and nausea and vomiting following colorectal cancer surgery.

Methods: A prospective, two-arm (1:1), single-blind, randomized controlled trial was conducted with 84 patients who underwent colorectal cancer surgery. Patients were randomly assigned to either the gum-chewing group (n = 42) or the control group (n = 42). The gum-chewing group began chewing gum on the first postoperative day, chewing one piece for 15 min three times daily, while the control group received standard care. Recovery of bowel function was assessed by monitoring bowel sounds (every 2 h by the same investigator), patient-reported first passage of flatus, and documented first defecation. Data were collected using an individual information form, the Eastern Cooperative Oncology Group performance score, and relevant clinical records.

Results: Significant differences were found between groups. The gum-chewing group had a shorter time to return of bowel sounds (8.94 ± 0.98 h vs. 15.86 ± 1.14 h), first passage of flatus (15.43 ± 4.48 h vs. 24.86 ± 13.90 h), and first defecation (22.86 ± 8.85 h vs. 30.74 ± 20.20 h) compared with the control group (p < 0.05).

Conclusion: Gum chewing effectively accelerated the recovery of bowel function after colorectal cancer surgery by reducing the time to return of bowel sounds, first passage of flatus, and first defecation.

Registration: www.

Clinicaltrials: gov NCT06029790.

Keywords: Bowel sounds; Colorectal cancer surgery; Flatus and defecation; Postoperative nausea vomiting; Surgical nursing care.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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