{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:03:48Z","timestamp":1791223428126,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":1754,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB-PG-0807-14113"],"award-info":[{"award-number":["PB-PG-0807-14113"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Bristol Nutrition Biomedical Research Unit"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chewing gum may stimulate gastrointestinal motility, with beneficial effects on postoperative ileus suggested in small studies. The primary aim of this trial was to determine whether chewing gum reduces length of hospital stay (LOS) after colorectal resection. Secondary aims included examining bowel habit symptoms, complications and healthcare costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This clinical trial allocated patients randomly to standard postoperative care with or without chewing gum (sugar-free gum for at least 10 min, four times per day on days 1\u20135) in five UK hospitals. The primary outcome was LOS. Cox regression was used to calculate hazard ratios for LOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 402 of 412 patients, of whom 199 (49\u00b75 per cent) were allocated to chewing gum, were available for analysis. Some 40 per cent of patients in both groups had laparoscopic surgery, and all study sites used enhanced recovery programmes. Median (i.q.r.) LOS was 7 (5\u201311) days in both groups (P = 0\u00b7962); the hazard ratio for use of gum was 0\u00b794 (95 per cent c.i. 0\u00b777 to 1\u00b715; P = 0\u00b7557). Participants allocated to gum had worse quality of life, measured using the EuroQoL 5D-3L, than controls at 6 and 12 weeks after operation (but not on day 4). They also had more complications graded III or above according to the Dindo\u2013Demartines\u2013Clavien classification (16 versus 6 in the group that received standard care) and deaths (11 versus 0), but none was classed as related to gum. No other differences were observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Chewing gum did not alter the return of bowel function or LOS after colorectal resection. Registration number: ISRCTN55784442 (http:\/\/www.controlled-trials.com).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10194","type":"journal-article","created":{"date-parts":[[2016,5,5]],"date-time":"2016-05-05T08:26:59Z","timestamp":1462436819000},"page":"962-970","source":"Crossref","is-referenced-by-count":44,"title":["Randomized clinical trial of postoperative chewing gum <i>versus<\/i> standard care after colorectal resection"],"prefix":"10.1093","volume":"103","author":[{"given":"C","family":"Atkinson","sequence":"first","affiliation":[{"name":"Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK"},{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C M","family":"Penfold","sequence":"additional","affiliation":[{"name":"Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK"},{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A R","family":"Ness","sequence":"additional","affiliation":[{"name":"Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK"},{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Longman","sequence":"additional","affiliation":[{"name":"Department of Coloproctology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S J","family":"Thomas","sequence":"additional","affiliation":[{"name":"Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK"},{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Hollingworth","sequence":"additional","affiliation":[{"name":"Schools of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kandiyali","sequence":"additional","affiliation":[{"name":"Schools of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S D","family":"Leary","sequence":"additional","affiliation":[{"name":"Schools of Oral and Dental Sciences, University of Bristol, Bristol, UK"},{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S J","family":"Lewis","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK"},{"name":"Department of Gastroenterology, Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,5,5]]},"reference":[{"key":"2021022216283865500_bjs10194-bib-0001","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.clnu.2015.01.016","article-title":"Postoperative ileus: recent developments in pathophysiology and management","volume":"34","author":"Bragg","year":"2015","journal-title":"Clin Nutr"},{"key":"2021022216283865500_bjs10194-bib-0002","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1007\/s00268-014-2506-2","article-title":"Reducing the burden of postoperative ileus: 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