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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(07): E887-E894
DOI: 10.1055/a-2335-8290
Review

Effect of chewing gum in bowel preparation for patients undergoing small bowel and colon capsule endoscopy: Systematic review with meta-analysis

Sofie Sajan Jensen
1   Department of Surgery, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
,
Ulrik Deding 
2   Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Ringgold ID: RIN6174)
1   Department of Surgery, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
,
Lea Østergaard Hansen 
1   Department of Surgery, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
,
Anastasios Koulaouzidis 
1   Department of Surgery, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
2   Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Ringgold ID: RIN6174)
,
Thomas Bjørsum-Meyer 
1   Department of Surgery, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
› Author Affiliations Clinical Trial: Registration number (trial ID): CRD42022385214, Trial registry: PROSPERO, Type of Study: prospective randomized controlled trial
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Abstract

Background and study aims Quality of bowel preparation and successful transit are critical factors for complete small bowel capsule endoscopy (SBCE) and colon capsule endoscopy (CCE). The aim of this systematic review with meta-analysis was to assess the impact of chewing gum as part of the bowel preparation regimen on the completion rate in both SBCE and CCE.

Methods A systematic literature search was conducted in PubMed, Cochrane, Web of Science and Embase. Data were extracted upon quality assessment of included studies. Two reviewers conducted the screening process according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Eighty-four studies met the search criteria and four randomized controlled trials were included in the meta-analysis, these were assessed for bias using Minors. Pooled completion rate of SBCE studies was defined as the primary outcome.

Results Three randomized controlled trials were SBCE studies and one was a CCE study. The pooled completion rate (91%) was not significantly higher in SBCE patients who were given chewing gum after capsule ingestion compared to those who were not (85%). Variance information was not reported in all studies, and therefore, pooled transit time estimates could not be calculated.

Conclusions Chewing gum has a good safety profile but has only been used as a booster in one CCE study and a few SBCE studies. More prospective randomized controlled trials, therefore, are needed to investigate the efficacy of chewing gum for achieving complete capsule examination.

Keywords

Endoscopy Small Bowel - Capsule endoscopy - Quality and logistical aspects - Preparation - Endoscopy Lower GI Tract

Supplementary Material



Publication History

Received: 15 November 2023

Accepted after revision: 05 April 2024

Article published online:
10 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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