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

BackgroundApproximately 1 in 6 capsule endoscopies (CEs) does not visualize the entire small bowel at completion of the examination because of limited battery life.ObjectiveTo determine whether chewing gum can reduce the small-bowel transit time and increase CE completion rates.DesignProspective, single-blind, randomized, controlled trial.SettingA tertiary university-affiliated hospital.PatientsConsecutive 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.InterventionGum chewing for at least 20 minutes every 2 hours starting at the time of capsule ingestion.Main Outcome MeasurementsSmall-bowel transit time, gastric transit time, and completion rate were measured.ResultsChewing 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.LimitationSingle-center study involving relatively healthy subjects. Procedures were done on an outpatient basis so participants were not monitored for adherence to protocol.ConclusionsChewing 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.)