Impact of Sugarless Chewing gum Versus Peppermint on First Bowel Movement after Cesarean Section: Randomized Controlled Trial

Background: Cesarean delivery (CD) became one of the commonest major surgical operations performed daily worldwide. Postoperative ileus (POI), Cesarean section (CS), is the most critical form of intestinal dysfunction that leads to absolute constipation and oral intake intolerance. It is mainly a result of a non-mechanical injury that disturbs the normal gastrointestinal tract motor activity.Objective: To assess which is more effective sugarless chewing gum or peppermint on first bowel movement after cesarean section. Patients and Methods: A randomized controlled study was conducted at Ain shams University Maternity Hospital in the period between (June to August 2021). The study included 300 full-term pregnant ladies after elective cesarean section under spinal anesthesia, aged 20-40, BMI ≤30and Hb ≥10. The patients had been randomly allocated to two groups: Group A received 200 ml of warm water with 2 packets of peppermint without sugar 2 hours after the surgery. Group B chewed sugarless chewing gum for 15 minutes 2 hours after the surgery.Results: Statistical analysis of current results showed that time to regain of GIT motility (4.4 ± 1.5 versus 2.8 ± 0.9 hours) and passage of flatus (8.3 ± 2.0 versus 7.1 ± 1.8 hours) were significantly longer among peppermint than gum group. Conclusion: Both peppermint and sugarless gum are effective nonpharmacological options for enhancement of post-cesarean section motility. The gum was more effective in shortening of time to regain GIT motility and passage of flatus with higher women’s acceptance. No side effects were noted except slight heartburn, nausea, and vomiting with peppermint of no significant importance.