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.
Apostolopoulos
P
P
Department of Gastroenterology, NIMTS Hospital, Athens, Greece. periklisapo@yahoo.com
Kalantzis
C
C
Gralnek
I M
IM
Liatsos
C
C
Tsironis
C
C
Kalantzis
N
N
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