Chewing Gum After Cardiac Surgery Can Aid Gut Health

Postoperative ileus can be quite a complex problem, a researcher says, but just a few sticks of gum are a “very simple” solution.

Chewing Gum After Cardiac Surgery Can Aid Gut Health

Chewing gum a few times daily is enough to jump-start the digestive systems of patients hospitalized after cardiac surgery, a single-center study suggests.

This isn’t the first time gum has been leveraged for bettering gut health, as it has a long history in colorectal, urology, and gynecological surgery. The idea is to prevent postoperative ileus, which can involve severe constipation and intolerance to an oral diet.

But Sirivan Seng, MD (Crozer Chester Medical Center, Upland, PA), and colleagues believe this is the first time it’s been studied specifically in the context of heart valve surgery and CABG.

Reporting their results virtually last week during the Society of Thoracic Surgeons’ Annual Perioperative and Critical Care Conference, Seng said that incidence of ileus can range from 0.39% to 5.50% among cardiac surgery patients. Risk factors include use of intra-aortic balloon pump, extended cardiopulmonary bypass pump time, and blood transfusion, as well as the presence of arrhythmias, sternal wound infection, and low postoperative cardiac output syndrome.

“Ileus in general is a very complex problem, and it’s unfortunately much more common than people think,” Seng told TCTMD. Other strategies for prevention include early ambulation and early feeding.

Cardiac surgery patients are “at risk, especially those who go on pump, where sometimes you are in a low-flow state, so your intestines are almost deprived of the nutrients that your blood brings you for just a temporary amount of time. But sometimes that’s enough to just put them into a little bit of a shock,” she explained.

“What’s nice about [the gum] is everybody can do it—it’s very simple,” said Seng. To follow the protocol, patients have to be able to interact with the cardiac team and follow directions, she advised, adding that if they don’t have teeth, “then of course they can’t chew gum.”

The researchers sought to test the strategy among patients who underwent elective on-pump CABG, aortic or mitral valve replacement, or mitral valve repair at their center. From 2017 to 2021, 341 people were assigned to chew one piece of sugarless gum three times daily for durations of at least 5 to 10 minutes during their hospital stay. This group was compared with 496 individuals who had cardiac surgery between 2013 and 2016 but weren’t instructed to use gum.

Two gum-chewing patients developed postoperative ileus, amounting to a rate of 0.59%. By comparison, 17 patients in the no-gum era—3.43%—had the gut condition (P = 0.005).

“Given the minimal risk and extremely trivial cost of this intervention, the incorporation of chewing gum following cardiac surgery should be strongly considered as a new standard of care,” Seng said in a press release.

  • Seng S, Orbay H, Geller C. To chew or not to chew? Preventing post-operative ileus in the cardiac surgery patient. Presented at: STS Perioperative and Critical Care Conference.

  • Seng reports no relevant conflicts of interest.