Effects of chewing gum and LI4 acupressure on gastrointestinal recovery after cesarean section: A randomized controlled trial

BACKGROUND: Postoperative gastrointestinal dysfunction is a frequent complication after cesarean section (CS), delaying recovery and causing discomfort. This study assessed the effects of chewing gum (CG) and LI4 acupressure-each compared with routine care-on gastrointestinal recovery after elective CS. METHODS: In this three-arm randomized controlled trial, 105 women undergoing elective CS were randomly allocated to CG plus routine care, acupressure plus routine care, or routine care alone (n = 35 each). Interventions were applied three times daily for two days. Primary outcomes were time to first gas passage and defecation; secondary outcomes included time to mobilization, postoperative abdominal pain (measured at six time points), and nausea/vomiting incidence. Analyses employed Kaplan-Meier survival curves, repeated-measures ANOVA, and chi-square tests. RESULTS: Both CG and acupressure groups showed significantly faster recovery than routine care, with shorter times to first gas passage, defecation, and mobilization (all p < 0.001). No significant differences were observed between CG and acupressure for these measures. A significant time × group interaction for pain (p = 0.025) indicated greater and more sustained relief in the acupressure group (all p < 0.05 vs. other groups). Nausea and vomiting rates were lower in intervention groups, though differences were not statistically significant. CONCLUSIONS: Chewing gum and LI4 acupressure each significantly enhanced postoperative gastrointestinal recovery after CS compared with routine care, while acupressure provided superior pain control. These simple, non-pharmacological methods may improve maternal recovery and comfort. Trial registration: Iranian Registry of Clinical Trials,IRCT20200206046395N3 (https://irct.behdasht.gov.ir/).