Tongue-Rotation Exercise Performance Recovers Intestinal Function After Cesarean Delivery: A Prospective Randomized Controlled Trial

Purpose: To investigate whether tongue-rotation exercises promote the recovery of bowel function after cesarean section. Background: Intestinal dysfunction after cesarean section is a serious complication. Chewing gum mastication is considered to promote the recovery of intestinal function after cesarean section. This effect is attributed to increased secretion of digestive hormones when chewing. A similar effect can be achieved with tongue-rotation exercise. However, whether this technique is effective for postoperative intestinal dysfunction remains unclear. Methods: This prospective, randomized, open-label trial enrolled women scheduled for elective cesarean section at our hospital (September 2022–March 2023). Participants were randomized to group C (usual postoperative fasting: no drinking for 2 hours and no eating for 6 hours) or group T (usual care plus tongue-rotation exercises 3 times daily from 2 hours postoperatively until first flatus). The primary end point was time to first flatus. Secondary end points included time to first bowel sounds/peristalsis, time to first bowel movement, length of stay, nausea/vomiting, ileus, abdominal distention, and salivary amylase activity before and after the exercise. Results: Sixty participants (30 per group) were analyzed, with no differences in baseline characteristics. Time to first flatus was significantly shorter in group T than in group C (927 ± 326 vs 1,233 ± 683 min; P = .031). No significant differences were observed in secondary end points. Conclusions: Tongue-rotation exercises may contribute to early recovery after cesarean section by improving bowel function, thereby facilitating postpartum childcare. Implications for Practice and Research: Practice: Tongue-rotation exercises may be a feasible, no-cost adjunct to standard postcesarean care to facilitate earlier return of bowel function when gum chewing is undesirable. Research: Larger trials comparing tongue rotation with chewing gum and evaluating patient-centered outcomes (comfort, feeding, breastfeeding, satisfaction) are warranted. Trial Registration: UMIN-CTR UMIN000055628; registered 2024-09-26; retrospectively registered.