Study objective: This systematic review and network meta-analysis aimed to compare the effects of coffee consumption and gum chewing on postoperative bowel function recovery in patients undergoing colorectal surgery. Design: Systematic review and network meta-analysis of randomized controlled trials. Patients: Patients undergoing colorectal surgery. Interventions: Coffee consumption and gum chewing for postoperative bowel function recovery. Measurements: The primary outcomes included the time to first defecation and flatus postoperatively. Secondary outcomes comprised the time to first toleration of food, length of hospital stay, time to first feeling of hunger, postoperative opioid analgesic use, incidence of complications, postoperative ileus, anastomotic leakage, nausea, vomiting, and in-hospital mortality. Main results: Twenty-one studies involving 1536 patients were included. Six studies compared coffee consumption to a control group, while 15 studies compared gum chewing to a control group. Compared with control groups, coffee consumption significantly reduced the time to first defecation mean difference (95% CI): −10.91 (−16.17, −5.65); I 2 = 43%; P < 0.0001 and flatus mean difference (95% CI): −6.38 (−11.89, −0.87); I 2 = 0%; P = 0.02. Similarly, gum chewing demonstrated significant reductions in time to first defecation mean difference (95% CI): −17.83 (−22.60, −13.07); I 2 = 83%; P < 0.00001 and flatus mean difference (95% CI): −13.71 (−17.88, −9.54); I 2 = 88%; P < 0.00001. Network meta-analysis revealed a non-significant trend favoring gum chewing over coffee for these outcomes. Notably, gum chewing provided additional clinical benefits including reduced incidence of postoperative ileus and shorter hospitalization. In contrast, coffee showed superior effects in facilitating earlier oral intake and reducing postoperative opioid requirements. Both interventions exhibited comparable safety profiles with no significant differences in complication rates. Conclusions: This study demonstrates that both chewing gum and coffee consumption can promote postoperative bowel function recovery in patients undergoing colorectal surgery, with chewing gum appearing to yield superior outcomes. Both interventions were significantly more effective than standard care in reducing the time to first flatus and first defecation. Trial registration: PROSPERO identifier: CRD420251114493. The protocol can be accessed at PROSPERO.
Gao et al. (Fri,) studied this question.