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Lit Review: Delayed return of gastrointestinal (GI) is a common postoperative complication that can delay feeding progression and increase hospital stay. Evidence suggests that chewing gum acts as a form of sham feeding by stimulating the cephalic-vagal pathway and promoting bowel motility (Short et al., 2015; Roslan et al., 2020). Multiple randomized controlled trials and meta-analyses have demonstrated earlier return of bowel function, including reduced time to first flatus and bowel movement, among postoperative patients who chewed gum compared with standard care (Bhatti et al., 2021; Hsu & Szu, 2022; Liao et al., 2022). Studies show improvements in bowel function recovery and feeding tolerance, although findings remain mixed (Rehana et al., 2022; Fung et al., 2024). Clinical significance lies in the potential for nurses to implement a simple, low-risk intervention that may enhance GI, improve patient comfort, and support earlier progression of postoperative care. PICO: Problem: Decreased or absent gastric motility post-operatively Population: Postoperative pediatric patients who are NPO or have NG tubes that are age appropriate (not a Choking risk) Change: Historically, there has not been an intervention to assist in the return of gastric motility in postoperative pediatric patients. The intervention being considered is the introduction of hard candy or chewing gum for the age-appropriate patient to assist in return of gut motility. Outcome: Staff nurse survey to assess their comfort and knowledge in utilizing hard candy or chewing gum to assist in the return of gastric motility postoperatively. Results: A total of 30 participants responded to the pilot survey. Most of the participants were nurses from general pediatrics and inpatient surgery. About 66% of the respondents believed chewing gum is beneficial for promoting bowel function after surgery. However, inconsistency was found in the likelihood of finding chewing gum in orders. Nearly 83% were somewhat comfortable or very comfortable in implementing chewing gum if put in orders. Respondents believed the benefits of chewing gum is a low-cost easy intervention that will assist in return of gut motility post-surgery, may prevent nausea, satisfy hunger feeling, may increase satisfaction, may improve progression to regular diet, and prevent ileus. Barriers in implementation of this strategy include not properly entering orders, age of the patient, availability of gum, and choking hazard. Therefore, increasing awareness, developing age-related criteria, and guidelines for order entry can assist in resolving the identified barriers.

Publication Date

11-9-2026

Keywords

Pediatric nursing

Popping Bubbles - Impact of Chewing Gum on Bowel Function in Pediatric Patients after Surgery

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