Efficacy of Chewing Xylitol Gum on Restoring Postoperative Bowel Activity After Laparoscopic Cholecystectomy: A Three-arm Randomized Controlled Trial.

Abstract

Purpose: The aim in the present study was to evaluate the effects of chewing postoperative xylitol gum on gastrointestinal functional recovery after laparoscopic cholecystectomy.

Design: A three-arm randomized controlled trial.

Methods: After a baseline assessment, participants were randomly assigned in three groups. The random assignment was performed by using a computer program (Microsoft Excel 2016). Afterward, participants were categorized into three subgroups. Group 3 was the control group that consisted of participants who had no intervention for chewing gum (n = 25). Group 2 was xylitol-free gum chewing group (n = 25), whereas Group 1 was xylitol gum chewing group (n = 24). In later phases, the time to first postsurgical flatus, time to first bowel sound after surgery, time to first postsurgical defecation, time to first mobilization after surgery, and discharge time from hospital were recorded. Nausea and vomiting, which are among the postoperative symptoms, were also evaluated.

Findings: The duration of the control group from the end of surgery to the flatulence and bowel sounds was statistically higher than the xylitol group and xylitol-free group (all P < .05). Also, first postoperative flatulence time of xylitol-free group was higher than the xylitol group (P < .05). The duration from the end of surgery to defecation was longer in the control group compared with the xylitol group and the xylitol-free group, with a statistically significant difference between the groups (P < .05). In this study, a statistically significant difference was observed in terms of the time to first postsurgical flatus, time to first bowel sound after surgery, and time to first postsurgical defecation (all P < .000). No significant difference was found between the xylitol group, xylitol-free group, and control group when discharge from hospital and mobilization times were analyzed (all of them are P > .05).

Conclusions: Chewing xylitol gum facilitates postoperative gastrointestinal recovery after laparoscopic cholecystectomy. Further studies are recommended to confirm these findings and investigate the underlying mechanisms.