title: Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: a single-blind randomized controlled trial.
abstract: OBJECTIVE
  Inadequate bowel cleaning leads to a suboptimal colonoscopic examination. Gum chewing has been reported to have a favorable effect on postoperative bowel functions. We conducted this study to establish if gum chewing added to high-dose senna before colonoscopy promotes bowel cleaning.
  
  
  METHODS
  In this randomized controlled study, consecutive outpatients scheduled for elective colonoscopy were randomized into two groups. Group 1 patients (n = 65) used senna solution 150 mL (300 mg senna) the night before colonoscopy. The patients also used sennoside tablet 80 mg daily for 3 days before the colonoscopy. Patients in group 2 (n = 64) were additionally advised to chew sugarless gum half an hour three-times daily after meals for these 3 days. The overall quality of colonoscopy cleaning was evaluated using the Aronchick scale by a single endoscopist who was blinded to the intervention. Difficulty of procedure, patients' tolerance, and adverse events were also evaluated.
  
  
  RESULTS
  A total 129 patients were enrolled in the study. Superior cleaning was found in gum chewing group when compared with other group particularly in the cecum and ascending colon. Cecal intubation time was significantly shorter in the gum-chewing group (8.6 ± 5.1 and 7.1 ± 2.8 min, P = 0.03). Adverse events were more common in group 1 compared to the gum-chewing group.
  
  
  CONCLUSIONS
  Gum chewing enhances colonoscopy bowel preparation quality. Moreover, it is a physiologically sound, safe, and an inexpensive part of the colonoscopy bowel preparation. Gum chewing could be advised in addition to high-dose senna containing bowel preparation.
authors.affiliation: Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Bilal
authors.initials: B
authors.lastname: Ergül
authors.forename: Levent
authors.initials: L
authors.lastname: Filik
authors.forename: Erdem
authors.initials: E
authors.lastname: Koçak
authors.forename: Zeynal
authors.initials: Z
authors.lastname: Doğan
authors.forename: Murat
authors.initials: M
authors.lastname: Sarıkaya
mesh_terms: D002638:Chewing Gum; D003113:Colonoscopy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D028321:Plant Preparations / Q000008:administration & dosage*; D029846:Senna Plant; D016037:Single-Blind Method
chemical_list: D002638:Chewing Gum; D028321:Plant Preparations