alexa Clinical trial: effectiveness of chewing-gum in accelerating capsule endoscopy transit time--a prospective randomized, controlled pilot study.


Journal of Gastrointestinal & Digestive System

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

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Abstract BACKGROUND: Capsule endoscopy (CE) fails to reach the caecum in approximately 20\% of patients. Data suggest that chewing-gum, simulating sham feeding, provokes the cephalic phase of gastrointestinal (GI) motor response and may increase GI motility. AIM: To determine whether chewing-gum increases the ability of CE reaching the caecum. 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 30 min every 2 h. Two blinded gastroenterologists examined all studies. The number of CE that reached the caecum within 8-h, gastric transit time (GTT) and small bowel transit time (SBTT) were evaluated in all patients. RESULTS: The CE percentage passed into the caecum was higher in the chewing-gum group compared 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 [40.8 min (interquartile range: 21-61 min) vs. 56.1 min (interquartile range: 22-78 min) (P = 0.045) and 229.1 min (interquartile range: 158-282 min) vs. 266.2 min (interquartile range: 204-307 min) (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 caecum without affecting CE image quality. This article was published in Aliment Pharmacol Ther and referenced in Journal of Gastrointestinal & Digestive System

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