Review article: the effectiveness of chewing-gum in accelerating capsule endoscopy transit time: a prospective randomized, controlled pilot study.

Author(s): Apostolopoulos P, Kalantzis C, Gralnek IM, Liatsos C, Tsironis C, Kalantzis N

Affiliation(s): Department of Gastroenterology, NIMTS Hospital, Athens, Greece.

Publication date & source: 2008-06-11, Aliment Pharmacol Ther., [Epub ahead of print]

Publication type:

Background: Capsule endoscopy (CE) fails to reach the cecum in approximately 20% of patients. Data suggest that chewing-gum, simulating sham feeding, provokes the cephalic phase of GI motor response and may increase gastrointestinal motility. Aim: To determine whether chewing-gum increases the ability of CE reaching the cecum. 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 30minutes every two hours. Two blinded gastroenterologists examined all studies. The number of CE reached the cecum, within 8-hours, gastric transit time(GTT) and small bowel transit time(SBTT) were evaluated in all patients. Results: The CE percentage passed into the cecum was higher in the chewing-gum group comparatively 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 [40.8minutes (inter-quartile range:21-61minutes) vs. 56.1minutes (inter-quartile range:22-78minutes (p=0.045) and 229.1minutes (inter-quartile range:158-282 minutes) vs. 266.2minutes (inter-quartile range:204-307minutes (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 cecum without affecting CE image quality.