The specific aim of this prospective, randomized controlled trial is to compare the effect of chewing gum on the return of bowel function in a group of patients undergoing spinal surgery with a group of matched controls that do not receive any chewing gum. A 24-hour reduction in time to passage of first flatus will be considered an important clinical difference. The research questions are: 1. Does providing chewing gum post-operatively hasten the return of bowel function? 2. Does providing chewing gum post-operatively reduced overall length of stay? 3. Does providing chewing gum post-operatively have any associated complications? 4. Does providing chewing gum post-operatively result in higher objective outcomes scores? The secondary aims are: 1. To compare hospital length of stay between the groups with a mean of ½ day considered clinically important. 2. To compare time until tolerating regular diet as defined as two consecutive meals with no complications with 24 hours considered statistically significant. 3. To compare incidence and nature of complications between the two groups. 4. To compare the time until completion of rehab milestones with 1 day being considered clinically important. 5. To compare the requirement for nutrition evaluations 6. To compare SF-12 scores as a marker of patient satisfaction with a difference of 10 points or more measured between the two groups upon discharge from hospital and at six-weeks after surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
144
Patients will be asked to chew gum three times a day for 30 minutes each time
Hospital for Special Surgery
New York, New York, United States
Time first pass flatus as a measure of return of bowel function.
Commencing on POD #0 patients will be asked to monitor the time they first pass flatus as a measure of return of bowel function.
Time frame: Up to two weeks
length of hospital stay
Time frame: Up to two weeks
time until tolerating regular diet
Time frame: Up to two weeks
post-operative narcotic usage
Time frame: Up to two weeks
pre-operative narcotic usage
Time frame: Up to two weeks
incidence complications
Time frame: Up to two weeks
time to completion of rehabilitation criteria for discharge
Time frame: Up to two weeks
requirement for nutrition evaluations
Time frame: Up to two weeks
NRS pain scores
Time frame: Up to two weeks
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