Post written by Yu Bai, MD, PhD, from the Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.

Polyethylene glycol (PEG) is widely used for bowel preparation; however, it is reported that up to 20 to 25% of patients have inadequate bowel preparation, so the methods to improve the quality of bowel preparation are being investigated extensively. From surgical literature, it is suggested that gum chewing can accelerate the gastrointestinal tract motility and reduce postoperative ileus. Therefore, we tried to determine the effect of gum chewing on bowel preparation for colonoscopy in addition to PEG. In a single-center, randomized controlled trial, 300 consecutive patients undergoing colonoscopy were randomized to a gum group or control group. The results indicated gum chewing cannot improve the quality of bowel preparation for colonoscopy, but it can improve patients’ satisfaction towards the process of bowel preparation and does not have negative effects on cleanliness.

Inadequate bowel preparation is frequently seen in clinical practice, and it is associated with missed adenomas, repeated procedures, and increased medical costs. It is very important to further improve the efficacy of PEG to reduce the occurrence of inadequate bowel preparation.

Figure 1. Flow diagram of patient enrollment.

For the primary endpoint, this was a negative study because gum chewing cannot increase the quality of bowel preparation, which was measured by BBPS. However, more patients in the gum chewing group completed the whole process of bowel preparation and felt more satisfied towards the process of bowel preparation; therefore, gum chewing may play a role in bowel preparation in addition to PEG intake. As the protocol of gum chewing before colonoscopy is not standardized, future studies shall investigate if increasing the number or shortening the interval of gum chewing will be more beneficial.

Find the article abstract here.

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