***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background / Aim : There is ample evidence in the recent literature that gum chewing after elective colonic anastomosis decreases postoperative ileus ( POI ) . But there are very few studies on small bowel anastomosis done in relaparotomy cases . This study aim ed to evaluate the effect of gum chewing on the duration of POI following small bowel anastomosis performed for the closure of intestinal stoma , made as temporary diversion in the selected cases of typhoid perforation peritonitis . Patients and Methods : Hundred patients undergoing elective small bowel anastomosis for the closure of stoma were r and omly assigned to the study group ( n=50 ) and the control group ( n=50 ) . The study group patients chewed gum thrice a day for 1 h each time starting 6 h after the surgery until the passage of first flatus . The control group patients had st and ard postoperative treatment . Results : Study and control group patients were comparable at inclusion . The mean time for the appearance of bowel sounds as well as the passage of first flatus was significantly shorter in the study group ( P=0.040 , P=0.006 ) . The feeling of hunger was also experienced earlier in study group cases ( P=0.004 ) . The postoperative hospital stay was shorter in the study group , but the difference was not significant ( P=0.059 ) . Conclusions : The cases of relaparotomy requiring additional adhesiolysis and small bowel anastomosis for stoma closure are benefited by postoperative gum chewing Background Gum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus . Objectives The current study assessed the effect of chewing sugar-free gum on the return of bowel function , where cesarean section had been performed in nulliparous women . Material s and Methods In a r and omized clinical trial , 60 patients , scheduled for cesarean section were r and omly divided in to 2 groups gum-chewing group ( n = 30 ) and control group ( n = 30 ) postoperatively . The patients in the gum-chewing group postoperatively chewed sugar free gum 3 times daily each time for 1 hour until discharge . The patients ' demographic characteristics , duration of surgery , mean hunger time , flatus and bowel motility were compared in the two groups . Results There was no significant difference between the 2 groups regarding patient demographics , intraoperative , and postoperative care . In the gum-chewing and the control group there was a significant difference in the mean postoperative interval of the first bowel movement ( 20.89 ± 8.8 versus 27.93 ± 9.3 hours , P = 0.004 ) , the first feeling of hunger ( 10.37 ± 6.0 versus 16.33 ± 9.3 hours , P = 0.005 ) , the first passage of flatus ( 25.02 ± 5.8 versus 31.08 ± 9.7 hours , P = 0.003 ) , and the first defecation ( 31.17 ± 5.3versus 40.08 ± 8.8 hours , P = 0.000 ) respectively , which were significantly shorter in the gum-chewing group compared to those of the control group . There were no major complications in either group . All patients in the gum-chewing group tolerated it without any major complications and side effects . Conclusions The study results demonstrated that bowel motility after cesarean section in nulliparous women can be accelerated by gum chewing which is a useful , inexpensive and well-tolerated method for mothers in post-cesarean section HYPOTHESIS Gum chewing after elective open colon resection may stimulate bowel motility and decrease duration of postoperative ileus . DESIGN AND SETTING Prospect i ve , r and omized study in a community-based teaching hospital . PATIENTS Thirty-four patients undergoing elective open sigmoid resections for recurrent diverticulitis or cancer . MAIN OUTCOME MEASURES First feelings of hunger , time to first flatus , time to first bowel movement , length of hospital stay , and complications . RESULTS A total of 34 patients were r and omized into 2 groups : a gum-chewing group ( n = 17 ) or a control group ( n = 17 ) . The patients in the gum-chewing group chewed sugarless gum 3 times daily for 1 hour each time until discharge . Patient demographics , intraoperative , and postoperative care were equivalent between the 2 groups . All gum-chewing patients tolerated the gum . The first passage of flatus occurred on postoperative hour 65.4 in the gum-chewing group and on hour 80.2 in the control group ( P = .05 ) . The first bowel movement occurred on postoperative hour 63.2 in the gum-chewing group and on hour 89.4 in the control group ( P = .04 ) . The first feelings of hunger were felt on postoperative hour 63.5 in the gum-chewing group and on hour 72.8 in the control group ( P = .27 ) . There were no major complications in either group . The total length of hospital stay was shorter in the gum-chewing group ( day 4.3 ) than in the control group ( day 6.8 ) , ( P = .01 ) . CONCLUSIONS Gum chewing speeds recovery after elective open sigmoid resection by stimulating bowel motility . Gum chewing is an inexpensive and helpful adjunct to postoperative care after colectomy Postoperative ileus is one of the common problems after abdominal surgeries . It contributes to delayed recovery and prolongs hospital stay . Sham feeding , such as gum chewing , may accelerate return of bowel function and reduce morbidity and length of hospital stay . This study aim ed to determine whether gum chewing in the immediate postoperative period facilitates a return to bowel function in cesarean-delivery patients . Three hundred eighty-eight patients who underwent cesarean delivery were r and omly assigned to a  gum-chewing group ( group G , N = 193 ) or a  control group  ( group C , N = 195 ) . Demographic data , duration of surgery , type of anesthesia , and time of discharge from hospital were recorded . Patients in the gum-chewing group chewed gum three times per day as soon as returning from the operating theater to the ward until the time they defecated or were discharged . Patients were asked to chew gum at least half an hour each time . The T test and Pearson chi-square test was used for statistical analysis . Groups were comparable in age , weight , height , weeks of gestation , duration of surgery , and type of anesthesia . Bowel sounds were 5 hours earlier in the gum-chewing group ( mean 18.2 hours ) than in the control group ( mean 23.2 hours ) . Passing flatus was 5.3 hours earlier in group G ( mean 34.6 hours ) than in group C ( mean 39.9 hours ) . Patients having mild ileus symptoms were 9 % less in group G ( mean 12 % ) than in group C ( mean 21 % ) . The difference between the two groups were all highly significant ( p < 0.001 ) . Gum chewing was easily tolerated without any complications . Gum chewing is an inexpensive , convenient , and physiological method in enhancing the recovery of bowel function . But this may not facilitate early hospital discharge , lactation , or defecation The aim of study was to investigate the effect of postoperative gum chewing on the recovery of bowel function after cesarean section . Total 100 women delivered by lower uterine segment section cesarean under local anesthesia ( spinal ) . Eligible patients were r and omly allocated into two groups : a gum-chewing group ( n=50 ) or a control group ( n= 50 ) . The gum-chewing group participants who received one stick of sugarless gum for one hours , three times daily immediately after recovery from anesthesia and the control group had the usual postoperative care until being discharged . All women were followed up regularly until discharge from hospital , and recorded the times to the ﬁrst bowel sounds of normal intestinal sounds , the time to the ﬁrst passage of ﬂatus , the time to the first feeling of hunger , and the time to the first defecation . The operative data , postoperative tolerance of gum chewing , and postoperative complications were documented . There was no statistically significant difference between the two groups in terms of demographic characteristics such as age , body mass index , parity , duration of surgery , number of miscarriages and curettages , time to the first feeding , the amount of serum intake , and type of cesarean section . The mean average postoperative interval of the first bowel sounds ( 21.9 versus 26.1 hours , p= 0.016 ) , the first feeling of hunger ( 11.8 versus 14.5 hours , p= 0.050 ) , the first passage of flatus ( 24.8 versus 30.0 hours , P=0.002 ) , the first defecation ( 30.6 versus 38.4 hours , P= 0.0001 ) was significantly shorter compared to the control group OBJECTIVE : To investigate the effect of postoperative gum chewing on bowel motility  after laparoscopic gynecologic surgery . METHODS : In this r and omized controlled trial , patients were allocated to either postoperative gum chewing every 2 hours for 15 minutes or st and ard postoperative care without gum chewing . The study 's primary end points were time to first regular bowel sounds and time to first passage of flatus after surgery . Secondary end points were time of operation to first defecation , patient satisfaction concerning postoperative gum chewing , potential side effects of postoperative gum chewing , and potential effect of gum chewing on postoperative pain therapy . RESULTS : One hundred seventy-nine patients were included in this trial . We found a significantly shorter interval between surgery and passage of first flatus in the intervention group compared with the control group ( median 6.2 hours compared with 8.1 hours ; P=.002 ) and a significantly higher rate of regular bowel sounds 3 hours ( 76 % compared with 47 % ; P<.001 ) and 5 hours ( 91 % compared with 78 % ; P=.01 ) after surgery . Fewer opioid analgetics were administered to patients allocated to the intervention group ( P=.02 ) . There was no significant difference in time to first defecation between groups ( median 26.3 hours compared with 29.0 hours , P=.165 ) . Gum chewing was well tolerated and well accepted by patients , and no intervention-related side effects were observed . CONCLUSION : Gum chewing seems to have beneficial effects on bowel motility when used as an adjunct treatment in postoperative care after minimally invasive surgery . Gum chewing should be recommended to patients after gynecologic laparoscopic surgery . CLINICAL TRIAL REGISTRATION : www . Clinical Trials.gov , NCT 01549353 . LEVEL OF EVIDENCE : Purpose To evaluate the effects of gum chewing on recovery of bowel function  after cesarean section . Methods Fifty pregnant women who underwent cesarean section at Chiang Mai University hospital from September 2010 to December 2010 were recruited . After cesarean section , patients were r and omized into two groups . In group 1 ( conventional ) , patients were fed according to conventional feeding protocol without gum chewing . For group 2 ( gum chewing ) , patients were asked to chew two pieces of sugarless gum for 30 min in the morning , noon , evening and bedtime until the first flatus , along with conventional postoperative feeding protocol . Categorical variables were analyzed using the Chi-square or Fischer ’s exact test , as appropriate . For continuous variables with skewed distribution , the Mann – Whitney U test was employed . Results There were 25 patients in each group .  Median time to the first flatus was shorter in the gum chewing group ( 36.37 vs. 41.33 h , P = 0.02 ) . Also , there was a trend toward less abdominal cramping on days 1 and 2 in the gum chewing group . However , no difference in other outcome measures of bowel function recovery and ileus-related complications between the groups could be demonstrated . Approximately three-fourth of the women in each group had good tolerance to their first meal . Hospital stay and participants ’ satisfaction to the assigned feeding schedules were comparable between the study groups . Conclusion Gum chewing is associated with faster recovery of bowel function  following cesarean section . It is safe , practical , inexpensive , and well tolerated Abstract Hypothesis : It is suggested that chewing gum may accelerate postoperative intestinal transit recovery . Chewing gum may therefore produce the same result after open appendectomy . Design and setting : Prospect i ve , r and omized study in a University teaching hospital . Patients : 46 patients operated on by open appendectomy due to acute catarrhal appendicitis , appendicular abscess and appendicular generalized peritonitis . Main outcome measures : Interest was in occurrence of first flatus , first bowel movement , hospital duration and complications . Results : A total of 46 patients were r and omly divided into two groups : a chewing gum group ( n = 23 ) and a control group ( n = 23 ) . In the first group , patients chewed sugarless gum for 30 minutes thrice daily until resumption of intestinal transit . Patient demographics , intra-operative , and postoperative care were the same for both groups . Chewing gum was well tolerated by all the patients . The first passage of flatus occurred on postoperative day 2.2 in the gum-chewing group and on day 3.0 in the control group ( P < 0.0001 ) . The first bow 
    Output:
    
We concluded that chewing gum probably reduces the length of hospital stay after an abdominal surgery