Cesarean delivery (CD) became one of the commonest major surgical operations performed daily
worldwide. Postoperative ileus (POI), Cesarean section (CS), is the most critical form of intestinal dysfunction that leads
to absolute constipation and oral intake intolerance. It is mainly a result of a non-mechanical injury that disturbs the
normal gastrointestinal tract motor activity. Objective: To assess which is more effective sugarless chewing gum or
peppermint on first bowel movement after cesarean section. Patients and Methods: A randomized controlled study
was conducted at Ain shams University Maternity Hospital in the period between (June to August 2021). The study
included 300 full-term pregnant ladies after elective cesarean section under spinal anesthesia, aged 20-40, BMI ≤30and
Hb ≥10. The patients had been randomly allocated to two groups: Group A received 200 ml of warm water with 2
packets of peppermint without sugar 2 hours after the surgery. Group B chewed sugarless chewing gum for 15 minutes
2 hours after the surgery. Results: Statistical analysis of current results showed that time to regain of GIT motility (4.4
± 1.5 versus 2.8 ± 0.9 hours) and passage of flatus (8.3 ± 2.0 versus 7.1 ± 1.8 hours) were significantly longer among
peppermint than gum group. Conclusion: Both peppermint and sugarless gum are effective nonpharmacological options
for enhancement of post-cesarean section motility. The gum was more effective in shortening of time to regain GIT
motility and passage of flatus with higher women’s acceptance. No side effects were noted except slight heartburn,
nausea, and vomiting with peppermint of no significant importance.