Effect of Chewing Gum on Bowel Function Recovery in Elderly Patients Following Posterior Lumbar Fusion Surgery: A Randomized Controlled Trial

Fuze Liu; Yifei Li; Gaoyang Li; Xiaoyan He; Lin Zhang; Meijia Zhang; Tian Liu; Ying Jiang; Qinlu Wang; Yaping Chen; Hai Wang

doi:10.1111/os.70391

Orthopaedic Surgery ›› 2026, Vol. 18 ›› Issue (8) :1641 -1648. DOI: 10.1111/os.70391

CLINICAL ARTICLE

Effect of Chewing Gum on Bowel Function Recovery in Elderly Patients Following Posterior Lumbar Fusion Surgery: A Randomized Controlled Trial

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Abstract

Objective: Given the paucity of prospective randomized evidence on chewing gum for postoperative bowel recovery in elderly spinal fusion patients, this study aimed to assess the efficacy of chewing gum in improving bowel function recovery in the elderly after posterior lumbar fusion surgery.

Methods: This study enrolled 119 elderly patients following posterior spinal fusion surgery between September 2023 and May 2025, and they were randomly assigned to either group 1 (chewing gum) or group 2 (control). The time for the first fluid intake, first oral intake, first sitting up, first bowel sounds, first flatus, and first defecation was recorded as outcome measures. Besides, the anesthesia usage controlled by patients after surgery, abdominal pain, distension, surgical wound pain, nausea, and abdominal girth were assessed and recorded at 24, 48, 72 h after surgery. Statistical analyses were performed using independent t-test, Mann–Whitney U test, Chi-square test, or Fisher's exact test, as appropriate.

Result: There are no significant differences observed between the chewing gum and control groups in patient-controlled anesthesia usage, abdominal pain scores, distension scores, surgical wound pain scores, nausea scores, or abdominal girth (p > 0.05). Similarly, postoperative recovery parameters, including time to first fluid intake, oral intake, sitting up, first bowel sounds, first flatus, and first defecation, showed no statistically significant differences (p > 0.05).

Conclusion: In this single-center randomized controlled trial, chewing gum did not show a statistically significant effect on early postoperative bowel function recovery in elderly patients undergoing posterior lumbar fusion surgery.

Keywords

bowel function / chewing gum / elderly / spinal surgery

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Fuze Liu, Yifei Li, Gaoyang Li, Xiaoyan He, Lin Zhang, Meijia Zhang, Tian Liu, Ying Jiang, Qinlu Wang, Yaping Chen, Hai Wang. Effect of Chewing Gum on Bowel Function Recovery in Elderly Patients Following Posterior Lumbar Fusion Surgery: A Randomized Controlled Trial. Orthopaedic Surgery, 2026, 18 (8) : 1641-1648 DOI:10.1111/os.70391

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References

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[1]	R. Vather, S. Trivedi, and I. Bissett, “Defining Postoperative Ileus: Results of a Systematic Review and Global Survey,” Journal of Gastrointestinal Surgery 17 (2013): 962–972, https://doi.org/10.1007/s11605-013-2148-y.

[2]	M. G. Doorly and A. J. Senagore, “Pathogenesis and Clinical and Economic Consequences of Postoperative Ileus,” Surgical Clinics of North America 92 (2012): 259–272, https://doi.org/10.1016/j.suc.2012.01.010.

[3]	X. Du, Y. Ou, G. Jiang, W. Luo, and D. Jiang, “Chewing Gum Promotes Bowel Function Recovery in Elderly Patients After Lumbar Spinal Surgery: A Retrospective Single-Center Cohort Study,” Annals of Palliative Medicine 10 (2021): 1216–1223, https://doi.org/10.21037/apm-20-1077.

[4]	S. J. Fineberg, S. V. Nandyala, M. F. Kurd, et al., “Incidence and Risk Factors for Postoperative Ileus Following Anterior, Posterior, and Circumferential Lumbar Fusion,” Spine Journal 14 (2014): 1680–1685, https://doi.org/10.1016/j.spinee.2013.10.015.

[5]	Y. Li, S. Zheng, Y. Wu, et al., “Trends of Surgical Treatment for Spinal Degenerative Disease in China: A Cohort of 37,897 Inpatients From 2003 to 2016,” Clinical Interventions in Aging 14 (2019): 361–366, https://doi.org/10.2147/CIA.S191449.

[6]	M. Vazquez Roque and E. P. Bouras, “Epidemiology and Management of Chronic Constipation in Elderly Patients,” Clinical Interventions in Aging 10 (2015): 919–930, https://doi.org/10.2147/CIA.S54304.

[7]	T. H. Lee, J. S. Lee, S. J. Hong, et al., “Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation,” Journal of Neurogastroenterology and Motility 21 (2015): 121–125, https://doi.org/10.5056/jnm14077.

[8]	T. Asao, H. Kuwano, J. Nakamura, N. Morinaga, I. Hirayama, and M. Ide, “Gum Chewing Enhances Early Recovery From Postoperative Ileus After Laparoscopic Colectomy,” Journal of the American College of Surgeons 195 (2002): 30–32, https://doi.org/10.1016/s1072-7515(02)01179-1.

[9]	C. A. Helman, “Chewing Gum Is as Effective as Food in Stimulating Cephalic Phase Gastric Secretion,” American Journal of Gastroenterology 83 (1988): 640–642.

[10]	Y. Meng, T. Lin, W. Shao, et al., “A Prospective Single-Blind Randomized Controlled Trial of Chewing Gum on Bowel Function Recovery After Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis,” Clinical Spine Surgery 31 (2018): 132–137, https://doi.org/10.1097/BSD.0000000000000629.

[11]	C. Y. W. Chan, C. K. Chiu, C. K. Lee, et al., “Usage of Chewing Gum in Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial,” Spine (Phila Pa 1976) 42 (2017): 1427–1433, https://doi.org/10.1097/BRS.0000000000002135.

[12]	J. K. Jennings, J. S. Doyle, S. R. Gilbert, M. J. Conklin, and J. G. Khoury, “The Use of Chewing Gum Postoperatively in Pediatric Scoliosis Patients Facilitates an Earlier Return to Normal Bowel Function,” Spine Deformity 3 (2015): 263–266, https://doi.org/10.1016/j.jspd.2014.12.001.

[13]	N. R. Hendrickson, Y. Zhang, L. Amoafo, et al., “Risk Factors for Postoperative Ileus in Patients Undergoing Spine Surgery,” Global Spine Journal 13 (2023): 2176–2181, https://doi.org/10.1177/21925682221075056.

[14]

J. A. Horowitz, A. Jain, V. Puvanesarajah, R. Qureshi, and H. Hassanzadeh, “Risk Factors, Additional Length of Stay, and Cost Associated With Postoperative Ileus Following Anterior Lumbar Interbody Fusion in Elderly Patients,” World Neurosurgery 115 (2018): e185–e189, https://doi.org/10.1016/j.wneu.2018.04.006.

[15]	W. M. Durand, J. H. Ruddell, A. E. M. Eltorai, J. M. DePasse, and A. H. Daniels, “Ileus Following Adult Spinal Deformity Surgery,” World Neurosurgery 116 (2018): e806–e813, https://doi.org/10.1016/j.wneu.2018.05.099.

[16]	P. D. Kiely, L. E. Mount, J. Y. Du, et al., “The Incidence and Risk Factors for Post-Operative Ileus After Spinal Fusion Surgery: A Multivariate Analysis,” International Orthopaedics 40 (2016): 1067–1074, https://doi.org/10.1007/s00264-016-3148-9.

[17]	K. Swong, S. Johans, A. Molefe, et al., “Unintended Consequences After Postoperative Ileus in Spinal Fusion Patients,” World Neurosurgery 122 (2019): e512–e515, https://doi.org/10.1016/j.wneu.2018.10.093.

[18]

C. Gifford, A. J. Minnema, J. Baum, M. L. Humeidan, D. E. Vazquez, and H. F. Farhadi, “Development of a Postoperative Ileus Risk Assessment Scale: Identification of Intraoperative Opioid Exposure as a Significant Predictor After Spinal Surgery,” Journal of Neurosurgery: Spine 31 (2019): 748–755, https://doi.org/10.3171/2019.5.SPINE19365.

[19]	B.-U. Kang, W.-C. Choi, S.-H. Lee, et al., “An Analysis of General Surgery-Related Complications in a Series of 412 Minilaparotomic Anterior Lumbosacral Procedures,” Journal of Neurosurgery: Spine 10 (2009): 60–65, https://doi.org/10.3171/2008.10.SPI08215.

[20]	M. A. Al Maaieh, J. Y. Du, A. Aichmair, et al., “Multivariate Analysis on Risk Factors for Postoperative Ileus After Lateral Lumbar Interbody Fusion,” Spine 39 (2014): 688–694, https://doi.org/10.1097/BRS.0000000000000238.

[21]	D. Bragg, A. M. El-Sharkawy, E. Psaltis, C. A. Maxwell-Armstrong, and D. N. Lobo, “Postoperative Ileus: Recent Developments in Pathophysiology and Management,” Clinical Nutrition 34 (2015): 367–376, https://doi.org/10.1016/j.clnu.2015.01.016.

[22]	O. Iskander, “An Outline of the Management and Prevention of Postoperative Ileus: A Review,” Medicine (Baltimore) 103 (2024): e38177, https://doi.org/10.1097/MD.0000000000038177.

[23]

H. M. Quah, A. Samad, A. J. Neathey, D. J. Hay, and A. Maw, “Does Gum Chewing Reduce Postoperative Ileus Following Open Colectomy for Left-Sided Colon and Rectal Cancer? A Prospective Randomized Controlled Trial,” Colorectal Disease 8 (2006): 64–70, https://doi.org/10.1111/j.1463-1318.2005.00884.x.

[24]	X.-Q. Liao, S.-L. Li, Y.-C. Peng, L.-W. Chen, and Y.-J. Lin, “Effects of Chewing Gum on Gastrointestinal Function in Patients Following Spinal Surgery: A Meta-Analysis and Systematic Review,” European Spine Journal 31 (2022): 2536–2546, https://doi.org/10.1007/s00586-022-07304-w.

[25]

L. Craciunas, M. S. Sajid, and A. S. Ahmed, “Chewing Gum in Preventing Postoperative Ileus in Women Undergoing Caesarean Section: A Systematic Review and Meta-Analysis of Randomised Controlled Trials,” BJOG: An International Journal of Obstetrics and Gynaecology 121 (2014): 793–799, https://doi.org/10.1111/1471-0528.12696.

[26]	H. Tandeter, “Hypothesis: Hexitols in Chewing Gum May Play a Role in Reducing Postoperative Ileus,” Medical Hypotheses 72 (2009): 39–40, https://doi.org/10.1016/j.mehy.2008.06.044.