Simple, obvious and cheap solutions to common problems are always welcome. However, despite this trial of chewing gum and bowel motility following caesarean section1 being registered with the international database of clinical trials, no mention is made in the methodology as to the ingredients of the substance administered for medicinal purposes, which in this case is chewing gum. Many so-called 'sugar free' chewing gums contain substances such as sorbitol that are known to cause diarrhoea.2 The authors only briefly suggest that the beneficial effect of the gum resulted from a physiological 'cephalic-vagal mechanism', and do not put forward any other hypothesis. Furthermore, the authors do not discuss any other simple and low-cost stimulants of gastric motility, such as erythromycin.
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