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.)