<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04489875</url>
  </required_header>
  <id_info>
    <org_study_id>456-784-9</org_study_id>
    <nct_id>NCT04489875</nct_id>
  </id_info>
  <brief_title>Gum Chewing Reduces the Risk of Postoperative Ileus After Arthroplasty Procedures in The Elderly Population</brief_title>
  <official_title>Gum Chewing Reduces the Risk of Postoperative Ileus After Arthroplasty Procedures in The Elderly Population: A Parallel Design, Open-Label, Randomized Controlled Trial</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Indus Hospital and Health Network</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Aga Khan University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Indus Hospital and Health Network</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Postoperative ileus (POI) is defined as a temporary cessation of bowel movement after a&#xD;
      surgical procedure. Surgical procedures not only include abdominal or colorectal procedures&#xD;
      but non-abdominal procedures as well. Cessation of bowel movement not only leads to&#xD;
      disturbing constipation but also may lead to nausea, loss of appetite, and food intolerance.&#xD;
      These patients tend to have more pain scores and dissatisfaction with the surgical management&#xD;
      and team. The mechanism behind this condition is caused by a decrease in vagal&#xD;
      parasympathetic stimulation. To break/prevent this mechanism, here comes the &quot;sham feeding&quot;&#xD;
      (gum-chewing) effect where an increase in chewing and saliva enhances the gastric emptying&#xD;
      and overall motility of gut as a cephalic phase of digestion even in non-gastro or colorectal&#xD;
      surgeries. This effect is studied thoroughly in gastric, colorectal, and gynecological&#xD;
      procedures. There is scarcity about its effect following orthopedic procedures specifically&#xD;
      hip arthroplasty. The objective of this study is to assess the effect of adding gum-chewing&#xD;
      to the conventional postoperative feeding regimen on restoring postoperative bowel function&#xD;
      and length of stay in hospital of patients undergoing elective hip arthroplasty.&#xD;
&#xD;
      Interventions:&#xD;
&#xD;
      Behavioral intervention (Chewing gum) will be started the morning after surgery when the&#xD;
      patient is fully awake and allowed to start taking an oral diet (which usually starts within&#xD;
      6-10 hours after surgery). In addition to the conventional postoperative feeding schedule,&#xD;
      the patient will be given the gum to chew for at least 15 minutes each time, 3 times/day&#xD;
      before the usual time of the meal, until the first flatus. The control group will have a&#xD;
      conventional feeding schedule without chewing gum being added to their meals.&#xD;
&#xD;
      Hypothesis:&#xD;
&#xD;
      The investigators hypothesize that there is an association between gum chewing and the relief&#xD;
      from postoperative ileus in hip arthroplasty patients.&#xD;
&#xD;
      Study Design:&#xD;
&#xD;
      Single-center, open-label, parallel design, superiority randomized-controlled trial with 2&#xD;
      treatment arms. The primary outcome will be the time interval in hours from the end of&#xD;
      surgery until the passage of flatus, which is reported subjectively by the patient. The&#xD;
      secondary outcome will be the time interval in hours from the end of surgery until the&#xD;
      passage of stool. The other secondary outcome will be the postoperative hospital stay in days&#xD;
      (surgery to discharge).&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Study Enrollment Procedures Enrollment will be a continuous process with screening and&#xD;
      enrolling eligible patients admitted through the clinic electively for primary THR. Informed&#xD;
      consent will be taken from the patient as per routine protocol before the arthroplasty&#xD;
      procedures in the hospital. Research objectives, methodology, risks, and benefits will be&#xD;
      explained in detail. Consent for the participation in the study will only be taken by the&#xD;
      primary investigator at his clinic or the surgical resident on call preoperatively along with&#xD;
      the consent for the surgical procedure.&#xD;
&#xD;
      Pre-Randomization Evaluations Screening The screening will involve the routine history taking&#xD;
      and physical examination by the doctor and nursing staff in the clinic. Screening won't&#xD;
      involve performing procedures that are not part of routine management. Special attention will&#xD;
      be given on assessing the dental history and whether the patient is able to chew gum.&#xD;
&#xD;
      On-study/on-intervention evaluations After screening and eligibility, patients will be&#xD;
      randomly allocated by a 1:1 ratio to the gum-chewing (gum) or control (no gum) groups using a&#xD;
      computer-generated randomization sequence by the clinical trials unit (CTU), which they will&#xD;
      provide to the PI, after patients' admission in the hospital. Patients will be followed from&#xD;
      the time they reach the ward after surgery until their hospital discharge, which is usually&#xD;
      around 7 days.&#xD;
&#xD;
      Data Collection:&#xD;
&#xD;
      Training of data collectors will be done by the PI to ensure the reliability and validity of&#xD;
      the study. Data collectors will be recruited, preferably nurses or residents familiar with&#xD;
      the hospital information management system (HIMS), the medical records and the CTU protocols.&#xD;
      Training of data collectors will be done, and collectors will be strictly instructed to&#xD;
      respect the autonomy of participants. Data collection will be done by the data collectors&#xD;
      under the supervision of the PI and CTU. Questionnaires will be checked for consistency and&#xD;
      logical data entries. Data entry will be done, and counter checked by the PI at regular&#xD;
      intervals.&#xD;
&#xD;
      Data Storage:&#xD;
&#xD;
      Data collected will be coded and kept confidential without the identifiable information of&#xD;
      patients. The confidentiality of the study participants will be maintained throughout the&#xD;
      study period. Data collected will be kept confidential without identifiable information of&#xD;
      patients who are identified by a number assigned. The hard copy forms will be retained in a&#xD;
      secured location with the PI after data entry into computer software and will be kept as per&#xD;
      hospital protocol. The password-protected drives will be used to store data with only the PI&#xD;
      having access to it. The data will be available for AKU ethical review committee on request&#xD;
      and might be published in a journal without disclosing any identifiable information of&#xD;
      patients. Filled questionnaires will be stored for 5 years after the study is completed as&#xD;
      per the policy of the institute.&#xD;
&#xD;
      Sample Size:&#xD;
&#xD;
      To the best of author's knowledge, this is the first research to study the effect of the&#xD;
      gum-chewing post-arthroplasty procedure on time to flatus. Literature reported numerous&#xD;
      studies on the same objective but only on post abdominal and colorectal surgery patients&#xD;
      which gave minimum mean time to flatus post-surgery of 67 hours [3]. In arthroplasty, no&#xD;
      handling of abdominal viscera is done, and the investigators assume the time of bowel return&#xD;
      to function is considerably less. Hence, considering the rarity of previous literature and&#xD;
      the number of cases to be operated in 6 months, investigators decided to recruit and study&#xD;
      all the eligible patients during the study period from July 2020 to December 2020. The&#xD;
      expected number of patients will be of 50 patients in each arm.&#xD;
&#xD;
      Plan of Analysis:&#xD;
&#xD;
      Statistical analysis will be done by using STATA software version 15. Mean ± SD will be&#xD;
      computed for all the normally distributed quantitative variables. The median and&#xD;
      interquartile range would be reported for the non-normally distributed quantitative&#xD;
      variables. The categorical variables would be expressed in frequencies and percentages.&#xD;
      Length of stay will be calculated by Kaplan-Meier analysis, with an unadjusted comparison of&#xD;
      groups by mantel-cox log-rank test. Risk ratios for the time-to-become ileus free and&#xD;
      time-to-discharge from the hospital will be calculated by cox proportional hazard regression&#xD;
      model, considering the following independent variables: age, gender, operation type, diabetes&#xD;
      mellitus, preoperative cardiovascular disease (ischemia /heart failure/dysrhythmias), PCA&#xD;
      opiate use and presence/absence of chewing gum.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">September 2020</start_date>
  <completion_date type="Anticipated">September 2021</completion_date>
  <primary_completion_date type="Anticipated">June 2021</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Prevention</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Passage of Flatus</measure>
    <time_frame>up to 12 hours post-operatively</time_frame>
    <description>the time interval in hours from the end of surgery until the first passage of flatus, which is reported subjectively by the patient. Patients will be instructed to make note of the time when flatus is passed for the first time after surgery.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>passage of stool</measure>
    <time_frame>up to 24 hours post-operatively</time_frame>
    <description>the time interval in hours from the end of surgery until the first passage of stool, which is reported subjectively by the patient. Patients and the bedside nurse will be instructed to make note of the time when the stool is passed for the first time after surgery.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">50</enrollment>
  <condition>Paralytic Ileus</condition>
  <arm_group>
    <arm_group_label>Chewing gum</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>the patients in this arm will receive the post-operative oral feeding along with chewing gum which they'll be required to chew for at least 15 minutes before their meal 3 times a day</description>
  </arm_group>
  <arm_group>
    <arm_group_label>No chewing gum</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>The patients in this arm will only receive the post-operative oral feeding</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Chewing Gum</intervention_name>
    <description>The intervention would be chewing gum. The patients in the intervention arm would be asked to chew gum for 15 minutes before meals thrice a day.</description>
    <arm_group_label>Chewing gum</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Adult patients aged 50-70 years&#xD;
&#xD;
          -  Undergoing elective primary hip arthroplasty surgery&#xD;
&#xD;
          -  ASA grade I, II, and III&#xD;
&#xD;
          -  The patients undergoing general anesthesia with/without neuraxial anesthesia&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients refusing to consent&#xD;
&#xD;
          -  Patients already having an established nasogastric (NG) tube/gastrostomy feeding, or&#xD;
             unsafe/unable to swallow due to any neurological condition&#xD;
&#xD;
          -  Patients with documented bowel disease other than peptic ulcers&#xD;
&#xD;
          -  History of chronic constipation more than 3 days before surgery&#xD;
&#xD;
          -  Inability to chew gum due to dental issues&#xD;
&#xD;
          -  traumatic and revision cases of arthroplasty&#xD;
&#xD;
          -  adjuvant surgical procedures (abdominal, thoracic, etc.) besides the primary&#xD;
             arthroplasty procedure will also be excluded from the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>50 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Obada Hassan, MSc. Epibio</last_name>
    <role>Principal Investigator</role>
    <affiliation>Aga Khan University</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Shahryar Noordin, MBBS</last_name>
    <phone>+922134864350</phone>
    <phone_ext>4350</phone_ext>
    <email>shahryar.noordin@aku.edu</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Dilshad Begum</last_name>
    <phone>+922134862303</phone>
    <phone_ext>2303</phone_ext>
    <email>dilshad.begum@aku.edu</email>
  </overall_contact_backup>
  <reference>
    <citation>Kalyanwat as, jakhar m, jain s. Postoperative ileus: a study on the role of chewing gum to reduce its duration. Saudi surgical journal. 2018 jul 1;6(3):85.</citation>
  </reference>
  <reference>
    <citation>Begum s, shahzad n, murtaza g, rehman zu, hasnain zafar gc. Of post-operative ileus after colorectal surgeries: a randomized control trial. Clinics of sugery. 2018; 1 (1): 1-5. Age (years). 2018;55(13.5):51-9.</citation>
  </reference>
  <reference>
    <citation>Matros E, Rocha F, Zinner M, Wang J, Ashley S, Breen E, Soybel D, Shoji B, Burgess A, Bleday R, Kuntz R, Whang E. Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg. 2006 May;202(5):773-8. doi: 10.1016/j.jamcollsurg.2006.02.009.</citation>
    <PMID>16648017</PMID>
  </reference>
  <reference>
    <citation>van den Heijkant TC, Costes LM, van der Lee DG, Aerts B, Osinga-de Jong M, Rutten HR, Hulsewe KW, de Jonge WJ, Buurman WA, Luyer MD. Randomized clinical trial of the effect of gum chewing on postoperative ileus and inflammation in colorectal surgery. Br J Surg. 2015 Feb;102(3):202-11. doi: 10.1002/bjs.9691. Epub 2014 Dec 18.</citation>
    <PMID>25524125</PMID>
  </reference>
  <reference>
    <citation>Atkinson C, Penfold CM, Ness AR, Longman RJ, Thomas SJ, Hollingworth W, Kandiyali R, Leary SD, Lewis SJ. Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. Br J Surg. 2016 Jul;103(8):962-70. doi: 10.1002/bjs.10194. Epub 2016 May 5.</citation>
    <PMID>27146793</PMID>
  </reference>
  <results_reference>
    <citation>Karmali S, Jenkins N, Sciusco A, John J, Haddad F, Ackland GL; POM-X Study Investigators. Randomized controlled trial of vagal modulation by sham feeding in elective non-gastrointestinal (orthopaedic) surgery. Br J Anaesth. 2015 Nov;115(5):727-35. doi: 10.1093/bja/aev283. Epub 2015 Aug 30.</citation>
    <PMID>26323293</PMID>
  </results_reference>
  <results_reference>
    <citation>Asao T, Kuwano H, Nakamura J, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002 Jul;195(1):30-2. doi: 10.1016/s1072-7515(02)01179-1.</citation>
    <PMID>12113542</PMID>
  </results_reference>
  <results_reference>
    <citation>Noble EJ, Harris R, Hosie KB, Thomas S, Lewis SJ. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg. 2009 Apr;7(2):100-5. doi: 10.1016/j.ijsu.2009.01.006. Epub 2009 Jan 31.</citation>
    <PMID>19261555</PMID>
  </results_reference>
  <verification_date>July 2020</verification_date>
  <study_first_submitted>June 1, 2020</study_first_submitted>
  <study_first_submitted_qc>July 27, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">July 28, 2020</study_first_posted>
  <last_update_submitted>July 28, 2020</last_update_submitted>
  <last_update_submitted_qc>July 28, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">July 30, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Indus Hospital and Health Network</investigator_affiliation>
    <investigator_full_name>Ahsun Jiwani</investigator_full_name>
    <investigator_title>Junior Biostatistician</investigator_title>
  </responsible_party>
  <keyword>Hip Arthroplasty</keyword>
  <keyword>Chewing gum</keyword>
  <keyword>Sham Feeding</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Ileus</mesh_term>
    <mesh_term>Intestinal Pseudo-Obstruction</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04489875
org study id: 456-784-9
nct id: NCT04489875
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Postoperative ileus (POI) is defined as a temporary cessation of bowel movement after a
      surgical procedure. Surgical procedures not only include abdominal or colorectal procedures
      but non-abdominal procedures as well. Cessation of bowel movement not only leads to
      disturbing constipation but also may lead to nausea, loss of appetite, and food intolerance.
      These patients tend to have more pain scores and dissatisfaction with the surgical management
      and team. The mechanism behind this condition is caused by a decrease in vagal
      parasympathetic stimulation. To break/prevent this mechanism, here comes the "sham feeding"
      (gum-chewing) effect where an increase in chewing and saliva enhances the gastric emptying
      and overall motility of gut as a cephalic phase of digestion even in non-gastro or colorectal
      surgeries. This effect is studied thoroughly in gastric, colorectal, and gynecological
      procedures. There is scarcity about its effect following orthopedic procedures specifically
      hip arthroplasty. The objective of this study is to assess the effect of adding gum-chewing
      to the conventional postoperative feeding regimen on restoring postoperative bowel function
      and length of stay in hospital of patients undergoing elective hip arthroplasty.

      Interventions:

      Behavioral intervention (Chewing gum) will be started the morning after surgery when the
      patient is fully awake and allowed to start taking an oral diet (which usually starts within
      6-10 hours after surgery). In addition to the conventional postoperative feeding schedule,
      the patient will be given the gum to chew for at least 15 minutes each time, 3 times/day
      before the usual time of the meal, until the first flatus. The control group will have a
      conventional feeding schedule without chewing gum being added to their meals.

      Hypothesis:

      The investigators hypothesize that there is an association between gum chewing and the relief
      from postoperative ileus in hip arthroplasty patients.

      Study Design:

      Single-center, open-label, parallel design, superiority randomized-controlled trial with 2
      treatment arms. The primary outcome will be the time interval in hours from the end of
      surgery until the passage of flatus, which is reported subjectively by the patient. The
      secondary outcome will be the time interval in hours from the end of surgery until the
      passage of stool. The other secondary outcome will be the postoperative hospital stay in days
      (surgery to discharge).
Study Enrollment Procedures Enrollment will be a continuous process with screening and
      enrolling eligible patients admitted through the clinic electively for primary THR. Informed
      consent will be taken from the patient as per routine protocol before the arthroplasty
      procedures in the hospital. Research objectives, methodology, risks, and benefits will be
      explained in detail. Consent for the participation in the study will only be taken by the
      primary investigator at his clinic or the surgical resident on call preoperatively along with
      the consent for the surgical procedure.

      Pre-Randomization Evaluations Screening The screening will involve the routine history taking
      and physical examination by the doctor and nursing staff in the clinic. Screening won't
      involve performing procedures that are not part of routine management. Special attention will
      be given on assessing the dental history and whether the patient is able to chew gum.

      On-study/on-intervention evaluations After screening and eligibility, patients will be
      randomly allocated by a 1:1 ratio to the gum-chewing (gum) or control (no gum) groups using a
      computer-generated randomization sequence by the clinical trials unit (CTU), which they will
      provide to the PI, after patients' admission in the hospital. Patients will be followed from
      the time they reach the ward after surgery until their hospital discharge, which is usually
      around 7 days.

      Data Collection:

      Training of data collectors will be done by the PI to ensure the reliability and validity of
      the study. Data collectors will be recruited, preferably nurses or residents familiar with
      the hospital information management system (HIMS), the medical records and the CTU protocols.
      Training of data collectors will be done, and collectors will be strictly instructed to
      respect the autonomy of participants. Data collection will be done by the data collectors
      under the supervision of the PI and CTU. Questionnaires will be checked for consistency and
      logical data entries. Data entry will be done, and counter checked by the PI at regular
      intervals.

      Data Storage:

      Data collected will be coded and kept confidential without the identifiable information of
      patients. The confidentiality of the study participants will be maintained throughout the
      study period. Data collected will be kept confidential without identifiable information of
      patients who are identified by a number assigned. The hard copy forms will be retained in a
      secured location with the PI after data entry into computer software and will be kept as per
      hospital protocol. The password-protected drives will be used to store data with only the PI
      having access to it. The data will be available for AKU ethical review committee on request
      and might be published in a journal without disclosing any identifiable information of
      patients. Filled questionnaires will be stored for 5 years after the study is completed as
      per the policy of the institute.

      Sample Size:

      To the best of author's knowledge, this is the first research to study the effect of the
      gum-chewing post-arthroplasty procedure on time to flatus. Literature reported numerous
      studies on the same objective but only on post abdominal and colorectal surgery patients
      which gave minimum mean time to flatus post-surgery of 67 hours [3]. In arthroplasty, no
      handling of abdominal viscera is done, and the investigators assume the time of bowel return
      to function is considerably less. Hence, considering the rarity of previous literature and
      the number of cases to be operated in 6 months, investigators decided to recruit and study
      all the eligible patients during the study period from July 2020 to December 2020. The
      expected number of patients will be of 50 patients in each arm.

      Plan of Analysis:

      Statistical analysis will be done by using STATA software version 15. Mean ± SD will be
      computed for all the normally distributed quantitative variables. The median and
      interquartile range would be reported for the non-normally distributed quantitative
      variables. The categorical variables would be expressed in frequencies and percentages.
      Length of stay will be calculated by Kaplan-Meier analysis, with an unadjusted comparison of
      groups by mantel-cox log-rank test. Risk ratios for the time-to-become ileus free and
      time-to-discharge from the hospital will be calculated by cox proportional hazard regression
      model, considering the following independent variables: age, gender, operation type, diabetes
      mellitus, preoperative cardiovascular disease (ischemia /heart failure/dysrhythmias), PCA
      opiate use and presence/absence of chewing gum.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Prevention
masking: None (Open Label)
measure: Passage of Flatus
time frame: up to 12 hours post-operatively
description: the time interval in hours from the end of surgery until the first passage of flatus, which is reported subjectively by the patient. Patients will be instructed to make note of the time when flatus is passed for the first time after surgery.
measure: passage of stool
time frame: up to 24 hours post-operatively
description: the time interval in hours from the end of surgery until the first passage of stool, which is reported subjectively by the patient. Patients and the bedside nurse will be instructed to make note of the time when the stool is passed for the first time after surgery.
arm group label: Chewing gum
arm group type: Experimental
description: the patients in this arm will receive the post-operative oral feeding along with chewing gum which they'll be required to chew for at least 15 minutes before their meal 3 times a day
arm group label: No chewing gum
arm group type: No Intervention
description: The patients in this arm will only receive the post-operative oral feeding
intervention type: Behavioral
intervention name: Chewing Gum
description: The intervention would be chewing gum. The patients in the intervention arm would be asked to chew gum for 15 minutes before meals thrice a day.
arm group label: Chewing gum
criteria: 
gender: All
minimum age: 50 Years
maximum age: 70 Years
healthy volunteers: No
last name: Obada Hassan, MSc. Epibio
role: Principal Investigator
affiliation: Aga Khan University
last name: Shahryar Noordin, MBBS
phone: +922134864350
phone ext: 4350
email: shahryar.noordin@aku.edu
last name: Dilshad Begum
phone: +922134862303
phone ext: 2303
email: dilshad.begum@aku.edu
citation: Kalyanwat as, jakhar m, jain s. Postoperative ileus: a study on the role of chewing gum to reduce its duration. Saudi surgical journal. 2018 jul 1;6(3):85.
citation: Begum s, shahzad n, murtaza g, rehman zu, hasnain zafar gc. Of post-operative ileus after colorectal surgeries: a randomized control trial. Clinics of sugery. 2018; 1 (1): 1-5. Age (years). 2018;55(13.5):51-9.
citation: Matros E, Rocha F, Zinner M, Wang J, Ashley S, Breen E, Soybel D, Shoji B, Burgess A, Bleday R, Kuntz R, Whang E. Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg. 2006 May;202(5):773-8. doi: 10.1016/j.jamcollsurg.2006.02.009.
PMID: 16648017
citation: van den Heijkant TC, Costes LM, van der Lee DG, Aerts B, Osinga-de Jong M, Rutten HR, Hulsewe KW, de Jonge WJ, Buurman WA, Luyer MD. Randomized clinical trial of the effect of gum chewing on postoperative ileus and inflammation in colorectal surgery. Br J Surg. 2015 Feb;102(3):202-11. doi: 10.1002/bjs.9691. Epub 2014 Dec 18.
PMID: 25524125
citation: Atkinson C, Penfold CM, Ness AR, Longman RJ, Thomas SJ, Hollingworth W, Kandiyali R, Leary SD, Lewis SJ. Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. Br J Surg. 2016 Jul;103(8):962-70. doi: 10.1002/bjs.10194. Epub 2016 May 5.
PMID: 27146793
citation: Karmali S, Jenkins N, Sciusco A, John J, Haddad F, Ackland GL; POM-X Study Investigators. Randomized controlled trial of vagal modulation by sham feeding in elective non-gastrointestinal (orthopaedic) surgery. Br J Anaesth. 2015 Nov;115(5):727-35. doi: 10.1093/bja/aev283. Epub 2015 Aug 30.
PMID: 26323293
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PMID: 19261555
responsible party type: Principal Investigator
investigator affiliation: Indus Hospital and Health Network
investigator full name: Ahsun Jiwani
investigator title: Junior Biostatistician
mesh term: Ileus
mesh term: Intestinal Pseudo-Obstruction
sharing ipd: No