Opinion: Want to Improve Patient Outcomes? Start Thinking Smaller – Inside Sources

According to a recent  American Association for Cancer Research study, there is a surprising and alarmingly steep rise in late-stage colon and rectal cancer in young adults. While we in the medical community aren’t quite sure why colorectal cancer is now affecting those in their 20s and 30s so aggressively, we are committed to helping them.

For more than a dozen years, I have specialized in the treatment of anorectal and intestinal disorders, including colorectal cancer, which is one of the world’s deadliest. It is also one of the most common. In the United States, the American Cancer Society projects more than 151,000 cases in 2022.

As any surgeon will say, nothing matters more than the ability to help patients with severe conditions realize full recoveries that allow them to return to their daily lives. Like most surgeons, I continue to be impressed by the dizzying array of new technologies at our disposal — such as the minimally invasive robotic surgery I use every day, which employs the latest advancements in surgical instrumentation to improve patient outcomes and satisfaction.

I appreciate the space-age technology, and my patients benefit from it. But there is a danger in getting too wrapped up in the new and shiny. Sometimes, the simple, tried-and-true things can be amazing — and help lead to superior outcomes. Since they often come at far less cost and far greater convenience to the patients, it’s easy to take them for granted or overlook them altogether. We shouldn’t.

For instance, I often prescribe my patients a simple painkiller after surgery — usually Tylenol or ibuprofen. Many in the medical community were wowed when more potent narcotics like opioids became available. While an important tool in pain management, these so-called “miracle drugs” turned out to be a double-edged sword with an unexpected social cost.

We also discovered that they have gut-slowing properties that can make a recovery from surgery more difficult. That’s why many doctors now prescribe non-opioid analgesics that are often just as effective at minimizing pain without the habit-forming or gut-slowing side effects.

And since speeding up gut recovery is so important after surgery, I have started feeding patients much sooner in their recovery. That’s because the chewing reflex is what stimulates the gut to “wake up” and gets the digestive tract moving again, thinking food is coming. This feeding can sometimes be achieved with real food — something as familiar as a handful of pretzels. However, I prescribe another simple intervention: chewing gum.

And I am not alone. There is growing evidence about gum’s benefits for patients recovering from many procedures involving gut health recovery — from colorectal surgery and heart surgery to hysterectomies and C-sections. In addition to helping “wake up” the bowels, gum can assist in preventing postoperative complications that result in nausea, abdominal distension and extended hospital stays.

There is mounting evidence that chewing gum also benefits before surgery, with one recent study showing how it can reduce anxiety in fasting pre-operative patients (building on previous research about how it can promote a greater sense of well-being overall with less stressanxiety or feelings of negativity).

Speaking from experience, my patients frequently report chewing gum as a source of comfort before and after surgery. Part of the reason is that chewing itself is one of the most basic pleasures in life. It not only adds a sense of normalcy to an otherwise stressful experience before an operation but can feel like a luxury after. It’s also a welcome alternative to yet another pill or invasive procedure.

While preventing colorectal cancer should be our goal — screening all adults 45 and older could save thousands of lives each year — once it is diagnosed, we should ensure the best possible outcome. Suppose something as simple and inexpensive as a stick of gum — or a Tylenol or a few pretzels — can make a real difference in patients’ health and finances. In that case, that’s just what I’m going to do.

Our duty as practitioners is to combine the best new technologies without ignoring simple solutions. My colleagues and I try to live and work by this mantra every day. 

Of course, the cutting-edge robotics technologies we employ are fantastic, and I look forward to what improvements the future will bring. But if our goal is to improve outcomes and overall well-being for our patients with the greatest access and lowest costs, then it also pays to think small.

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