gastrins and Flatulence

Prolonged intestinal paralysis can be a problem after gastrointestinal surgery. Several systematic reviews and meta-analyses have suggested the efficacy of gum chewing for the prevention of postoperative ileus.. The purpose of this study was to examine the efficacy of gum chewing for the recovery of bowel function after surgery for left-sided colorectal cancer and to determine the physiological mechanism underlying the effect of gum chewing on bowel function.. This was a single-center, placebo-controlled, parallel-group, prospective randomized trial.. The study was conducted at a general hospital in Japan.. Forty-eight patients with left-sided colorectal cancer were included.. The patients were randomly assigned to a gum group (N = 25) and a control group (N = 23). Four patients in the gum group and 1 in the control group were subsequently excluded because of difficulties in continuing the trial, resulting in the analysis of 21 and 22 patients in the respective groups. Patients in the gum group chewed commercial gum 3 times a day for ≥5 minutes each time from postoperative day 1 to the first day of food intake.. The time to first flatus and first bowel movement after the operation were recorded, and the colonic transit time was measured. Gut hormones (gastrin, des-acyl ghrelin, motilin, and serotonin) were measured preoperatively, perioperatively, and on postoperative days 1, 3, 5, 7, and 10.. Gum chewing did not significantly shorten the time to the first flatus (53 ± 2 vs. 49 ± 26 hours; p = 0.481; gum vs. control group), time to first bowel movement (94 ± 44 vs. 109 ± 34 hours; p = 0.234), or the colonic transit time (88 ± 28 vs. 88 ± 21 hours; p = 0.968). However, gum chewing significantly increased the serum levels of des-acyl ghrelin and gastrin.. The main limitation was a greater rate of complications than anticipated, which limited the significance of the findings.. Gum chewing changed the serum levels of des-acyl ghrelin and gastrin, but we were unable to demonstrate an effect on the recovery of bowel function.

Topics: Aged; Aged, 80 and over; Chewing Gum; Colectomy; Colon, Descending; Colonic Neoplasms; Defecation; Female; Flatulence; Gastrins; Gastrointestinal Motility; Ghrelin; Humans; Ileus; Japan; Length of Stay; Male; Middle Aged; Motilin; Postoperative Care; Postoperative Complications; Serotonin; Sigmoid Neoplasms; Treatment Outcome

The study was designed to investigate the influence of gum chewing on the return of gastrointestinal function after gastric abdominal surgery in children and the action of neural and humoral hormones in the mechanism of gum chewing.. Eighteen patients were enrolled in our study. Each patient underwent gastrointestinal surgery and was then randomly assigned to either the gum-chewing or the control group. The patients in the gum-chewing group chewed gum three times a day in the morning, the afternoon and the evening from the first postoperative morning until the day they began oral intake. The time of first passage of flatus was recorded to evaluate the return of bowel movement. Blood samples were taken immediately after the 3rd gum chewing for the analysis of gastrin and catecholamines (epinephrine, norepinephrine).. The first passage of flatus in the gum-chewing group was seen on average of 69 h after operation, which was significantly earlier than the average of 77 h in the control group (p < 0.05). However, in contrast to the time of first flatus, the values of blood catecholamines and gastrin showed no significant difference between the two groups.. Gum chewing hastens the return of intestinal function after gastric abdominal surgery in children. The mechanism by which gum chewing initiates an earlier return of gastrointestinal function is still unknown, although neural and humoral hormones are presumed to be mediators in stimulating bowel motility.

Topics: Catecholamines; Chewing Gum; Child; Child, Preschool; Digestive System Surgical Procedures; Female; Flatulence; Gastrins; Gastrointestinal Diseases; Gastrointestinal Motility; Humans; Male; Mastication; Postoperative Care

Fasting and post-prandial circulating levels of insulin, gastrin, gastric inhibitory polypeptide, pancreatic polypeptide and neurotensin were measured in patients with flatulent dyspepsia, with and without gallbladder disease and post-cholecystectomy. Levels were also measured in non-dyspeptic patients with gallbladder disease and normal controls. There were no consistent significant differences from controls for fasting and post-prandial responses in patients with a history of dyspepsia or those who experienced dyspepsia at the time of the test. In patients with gallbladder disease, with and without dyspepsia, there was a reduced neurotensin response compared to normal controls. It is concluded that circulating levels of these hormones are not related to symptoms of flatulent dyspepsia.

Topics: Dyspepsia; Female; Flatulence; Gallbladder Diseases; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Humans; Insulin; Male; Middle Aged; Neurotensin; Pancreatic Polypeptide