The effect of chewing gum on small-bowel transit time in capsule endoscopy: a prospective, randomized trial.

Background: Approximately 1 in 6 capsule endoscopies (CEs) does not visualize the entire small bowel at completion of the examination because of limited battery life.
Objective: To determine whether chewing gum can reduce the small-bowel transit time and increase CE completion rates.
Design: Prospective, single-blind, randomized, controlled trial.
Setting: A tertiary university-affiliated hospital.
Patients: Consecutive patients 19 years of age and older undergoing outpatient small-bowel CE from October 2010 to July 2012 were assessed for eligibility. Those with previous gastric or small-bowel surgery or ileostomy, dysphagia prohibiting capsule ingestion, diabetes mellitus with evidence of end-organ damage, use of narcotics or prokinetics within 5 days before the procedure, clinical hyper-/hypothyroidism, and symptoms suggestive of acute bowel obstruction were excluded.
Intervention: Gum chewing for at least 20 minutes every 2 hours starting at the time of capsule ingestion.
Main Outcome Measurements: Small-bowel transit time, gastric transit time, and completion rate were measured.
Results: Chewing gum did not have any significant effect on gastric transit time (rate ratio 1.06; 95% CI, 0.73-1.55; P = .75), small-bowel transit time (rate ratio 0.91; 95% CI, 0.62-1.35; P = .65), or completion rate (91.67% chewing gum vs 88.71% control, P = .58) of CE.
Limitation: Single-center study involving relatively healthy subjects. Procedures were done on an outpatient basis so participants were not monitored for adherence to protocol.
Conclusions: Chewing gum does not speed up capsule transit or increase completion rate of CE in patients without risk factors for incomplete studies. (
Clinical Trial Registration Number: NCT01241825.).
(Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.)