New Aspects of Chewing Gum – in Clinical Settings

By Miyoung Kim

Miyoung is currently in her second year of the MS coordinated dietetics program at University of Illinois at Chicago. This post is the eleventh installment of the new Student Series here on the CAND blog, which features Chicago-area dietetic interns every Thursday. Miyoung is passionate about many areas of clinical nutrition and dietetics including gastroenterology  – keep reading for her summary of the recent research on the use of chewing gum in the clinical setting. For Miyoung’s full bio, please see below.

New Aspects of Chewing Gum – in Clinical Settings

I recently read some creative journal articles about the benefits of chewing gum as a supportive tool in clinical settings. Have you ever imagined a relationship between gum and improvement of the gastrointestinal tract? Currently, gum is being reevaluated as a new approach to apply in the clinical setting due to its efficiency, low price, and relatively few side effects.

In new studies, researchers have shown that chewing sugar-free gum improves the symptoms of gastroesophageal reflux disease (GERD) and enhances recovery after abdominal surgery. GERD is a common global malady, sometimes causing individuals to have such uncomfortable symptoms that they have to visit the hospital with heartburn, regurgitation, and difficulty swallowing, caused by abnormal gastric acid reflux from the stomach into the esophagus. As a first line of treatment, proton pump inhibitors (PPIs) are generally prescribed for GERD, but taking a PPI for an extended period of time may lead to undesirable side effects.

But good news is emerging for long-time sufferers of GERD. Several randomized clinical trials showed that chewing sugar-free gum for 30 minutes after meals significantly reduced reflux in patients with GERD. The researchers explained two reasons for this effect. First, chewing gum increases the production of saliva, which washes out the gastric acid within the distal esophagus. Additionally, the pH of the saliva stimulated by chewing gum is higher (more basic) compared to the normally-released saliva, which neutralizes the gastric acid in the esophagus. Thus, the researchers concluded that chewing sugar-free gum could be considered a simpler method to reduce GERD symptoms.

Other studies demonstrated that chewing sugar-free gum enhanced recovery after abdominal surgeries because bowel movements are stimulated after chewing gum. One study evaluated chewing gums for enhancing postoperative recovery following a colectomy by comparing two groups of patients: one group chewing gum and one group not chewing gum post-operatively. The study compared the time it took to pass flatus after surgery as well as the length of stay in the hospital between the two groups. Interestingly, the results showed that the gum-chewing group had a significantly shorter time before passing flatus, meaning enhanced intestinal recovery after surgery. Furthermore, the gum group had a one-day reduced length of hospital stay compared to the control group. Apart from this study, several recent clinical trials also showed the improvement of intestinal recovery through reduced incidence of ileus and/or promotion of bowel motility by chewing gum after such surgeries as cesarean section, prostatectomy, and surgery for gynecological malignancies.

As the above studies suggest, chewing sugar-free or regular gum is a useful and effective tip for patients of GERD and in recovery after abdominal surgeries. Many researchers say that we should consider using chewing gum as one of the tools for improving GERD symptoms, or adding it to the postoperative care process. At the same time, we need to develop more clearly defined parameters for chewing gum, including frequency and duration of chewing as well as type of gum (sugar-free versus regular). Perhaps someone will invent a specialized gum to fulfill the requirements to apply in medical settings in the future!

References

(1) R.Moazzez et al., The effect of chewing sugar-free gum on gastro-esophageal reflux. J Dent Res. 2005; 84(11):1062-5.
(2) Sanjay Purkayastha et al., Meta-analysis of randomized studies evaluating chewing gum to enhance prospective recovery following colectomy. ARCH SURG. 2008; Vol 143 (No.8):788-793.
(3) Mohsenzadeh Ledari F et al., Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iran Red Crescent Med J.  2013; Apr 15(4):330-4.
(4) Jakkaew B et al., Effect of gum chewing on recovery of bowel function following cesarean section: a randomized controlled trial. Archives of Gynecology and Obstetrics.  2013; Aug 228(2):255-60.
(5) Choi H et al., Gum chewing promotes bowel motility after a radical retropubic prostatectomy. Asia Pac J Clin Oncol.  2013; Aug12.
(6) Ertas IE et al., Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: A randomized controlled tiral. Gynecol Oncol.  2013; Oct.
(7) Hocevar BJ et al., Does chewing gum shorten the duration of postoperative ileus in patients undergoing abdominal surgery and creation of a stoma? J Wound Ostomy Continence Nurs. 2010; Mar-Apr 27(2):140-6.
(8) Thomas J. Poulton et al., Gum chewing during pre-anesthetic fasting. Pediatric Anesthesia. 2012; (22):288-296.

Miyoung Kim is currently in her second year of the MS in coordinated dietetics program at University of Illinois at Chicago. She completed her BS in Food and Nutrition from SangJi University and MS in Food and Nutrition from Seoul National University in South Korea. She is passionate about clinical nutrition especially, in the Enteral & Parenteral Nutrition and Gastroenterology. She likes to meet people and to explore different cultures, foods, and languages. That is why she loves Chicago where is the Melting Pot! You can contact her at mk*****@*ic.edu.