Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial.
OBJECTIVE
Gum chewing can accelerate motility in the GI tract; clinical studies suggested gum chewing can reduce postoperative ileus. However, no trial has investigated the effect of gum chewing on bowel preparation for colonoscopy in addition to polyethylene glycol (PEG). The objective of this study was to investigate whether gum chewing before colonoscopy can increase the quality of bowel preparation.


METHODS
This was a single-center, randomized controlled trial. Consecutive patients undergoing colonoscopy were randomized to the gum group or the control group. Patients in the gum group chewed sugar-free gum every 2 hours for 20 minutes each time from the end of drinking 2 L of PEG to the beginning of colonoscopy. Patients in the control group only received 2 L of PEG before colonoscopy. The quality of bowel preparation, procedure time, adenoma detection rate, patients' tolerance, and adverse events were compared.


RESULTS
Three hundred patients were included in the study (150 in the control group, 150 in the gum group). More than 90% of patients in both groups were satisfied with the process of bowel preparation, and the incidence of adverse events was comparable in the 2 groups (41.3% vs 46.0%, P = .42). The mean Boston Bowel Preparation Scale score was 6.2 ± 1.4 and 6.1 ± 1.2 in the control group and the gum group, respectively, and the difference between the 2 groups was not significant (P = .51).


CONCLUSIONS
This study indicates that gum chewing does not improve the quality of bowel preparation for colonoscopy, but it can improve patients' satisfaction with the process of bowel preparation and does not have negative effects on cleanliness. (Clinical trials registration number: NCT02507037.).
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Jun
J
Fang
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Shu-Ling
SL
Wang
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Hong-Yu
HY
Fu
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Zhao-Shen
ZS
Li
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Yu
Y
Bai
D000236:Adenoma / Q000000981:diagnostic imaging*; D000328:Adult; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects; D002638:Chewing Gum / Q000009:adverse effects; D003113:Colonoscopy / Q000009:adverse effects / Q000592:standards; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D016037:Single-Blind Method
D002400:Cathartics; D002638:Chewing Gum; D011092:Polyethylene Glycols