Clinical trial: effectiveness of chewing-gum in accelerating capsule endoscopy transit time--a prospective randomized, controlled pilot study.
BACKGROUND
Capsule endoscopy (CE) fails to reach the caecum in approximately 20% of patients. Data suggest that chewing-gum, simulating sham feeding, provokes the cephalic phase of gastrointestinal (GI) motor response and may increase GI motility.


OBJECTIVE
To determine whether chewing-gum increases the ability of CE reaching the caecum.


METHODS
Prospective, randomized, single-blinded controlled trial. Ninety-three consecutive patients were randomized either to use chewing-gum (n = 47) or not (n = 46). All patients received the identical bowel preparation. Patients chewed one piece of gum for approximately 30 min every 2 h. Two blinded gastroenterologists examined all studies. The number of CE that reached the caecum within 8-h, gastric transit time (GTT) and small bowel transit time (SBTT) were evaluated in all patients.


RESULTS
The CE percentage passed into the caecum was higher in the chewing-gum group compared with those in the other (83.0% vs. 71.7% respectively, P = 0.19). Both GTT and SBTT were significantly shorter in the chewing-gum vs. control group [40.8 min (interquartile range: 21-61 min) vs. 56.1 min (interquartile range: 22-78 min) (P = 0.045) and 229.1 min (interquartile range: 158-282 min) vs. 266.2 min (interquartile range: 204-307 min) (P = 0.032) respectively]. Chewing-gum did not adversely affect CE image quality.


CONCLUSIONS
Chewing-gum significantly reduces GTT and SBTT during CE. Its use may improve the likelihood of the capsule reaching the caecum without affecting CE image quality.
Department of Gastroenterology, NIMTS Hospital, Athens, Greece. periklisapo@yahoo.com
P
P
Apostolopoulos
C
C
Kalantzis
I M
IM
Gralnek
C
C
Liatsos
C
C
Tsironis
N
N
Kalantzis
D053704:Capsule Endoscopy / Q000379:methods*; D002400:Cathartics / Q000008:administration & dosage; D002432:Cecum / Q000503:physiopathology*; D002638:Chewing Gum; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D002400:Cathartics; D002638:Chewing Gum