Loss of appetite after major abdominal surgery; the best therapy is…..chewing gum!

Loss of appetite after major abdominal surgery; the best therapy is chewing gum!

Unwanted loss of appetite after major abdominal surgery is a common problem and has significance for the prognosis of the patient. The cause lies in a reduced gastric reservoir, combined with a decrease in the formation of ghrelin ( an appetite promoting hormone ) in the stomach and decreased secretion of satiety hormones in the small bowel.

German investigators conducted a systemic review into this problem. They concluded that research into the problem is limited and heterogeneous. The studies analyzed include 20.506 patients.

The only treatment with a high burden of proof was chewing chewing gum, measured on the basis of the time until the first feeling of hunger. Next to that diet guidance, watching cooking shows and “rikkunshito” (a traditional Japanese herbal remedy) could stimulate appetite. Administration of sophisticated drugs such as ghrelin intravenously and 5-HT-agonists respectively showed various results or were investigated only once. Appetite stimulants such as cannabinoids and corticosteroids have not been investigated in surgical patients.

Unfortunately, it was not mentioned by the authors whether peppermint or a more sweet flavour of the gum had a better effect.

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