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BMC Gastroenterology

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Open Access 01-12-2018 | Research article

Can coffee or chewing gum decrease transit times in Colon capsule endoscopy? A randomized controlled trial

Authors: Maria Magdalena Buijs, Morten Kobaek-Larsen, Lasse Kaalby, Gunnar Baatrup

Published in: BMC Gastroenterology | Issue 1/2018

Abstract

Background

A high rate of complete colon capsule endoscopy (CCE) investigations is required for a more widespread use of CCE. The objective of this study was to assess if coffee or chewing gum can increase excretion of the colon capsule within battery life time (excretion rate).

Methods

One hundred eighty six screening participants with a positive immunochemical fecal occult blood test were included in this single-centre randomized controlled trial with blinding of the investigators to the randomization. Participants received instant coffee, chewing gum or nothing in addition to the standard bowel preparation.

Results

The intention was to include 57 participants in the coffee group, 61 in the chewing gum group and 60 in the control group, on 8 participants data were missing. A total of 165 participants were included in a per protocol analysis. Exclusion was due to not receiving the allocated intervention (8 coffee, 4 chewing gum) and technical failure of the capsule (1 coffee). The excretion rate was 58% in the coffee group (n = 48), 63% in the chewing gum group (n = 57) and 55% in the control group (n = 60, p > 0.2). Transit times were similar in all groups. The excretion rate was low in participants who had transit times over 10 h (14%). A strong correlation was found between adequate cleansing and excretion of the capsule.

There were no serious adverse events related to the interventions or CCE investigations.

Conclusions

Chewing gum and coffee did not improve excretion rate in this study. An effect of chewing gum could not be proven, possibly due to sample size. Since chewing gum might improve excretion rates, is cheap and has no known side effects, it needs to be considered in future bowel preparation trials for CCE.

Trial registration

NCT02303756, registered on December 1st 2014.

Available only for authorised users

Spada C, Barbaro F, Andrisani G, Minelli Grazioli L, Hassan C, Costamagna I, Campanale M, Costamagna G. Colon capsule endoscopy: what we know and what we would like to know. World J Gastroenterol. 2014;20(45):16948–55.CrossRefPubMedPubMedCentral

Spada C, Hassan C, Galmiche JP, Neuhaus H, Dumonceau JM, Adler S, Epstein O, Gay G, Pennazio M, Rex DK, et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2012;44(5):527–36.CrossRefPubMed

Holleran G, Leen R, O’Morain C, McNamara D. Colon capsule endoscopy as possible filter test for colonoscopy selection in a screening population with positive fecal immunology. Endoscopy. 2014;46(6):473–8.CrossRefPubMed

Rondonotti E, Borghi C, Mandelli G, Radaelli F, Paggi S, Amato A, Imperiali G, Terreni N, Lenoci N, Terruzzi V, et al. Accuracy of capsule colonoscopy and computed tomographic colonography in individuals with positive results from the fecal occult blood test. Clin Gastroenterol Hepatol: Offic Clin Pract J Am Gastroenterol Assoc. 2014;12(8):1303–10.CrossRef

Rex DK, Adler SN, Aisenberg J, Burch WC Jr, Carretero C, Chowers Y, Fein SA, Fern SE, Fernandez-Urien Sainz I, Fich A, et al. Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastroenterology. 2015;148(5):948–57. e942CrossRefPubMed

Allison JE, Sakoda LC, Levin TR, Tucker JP, Tekawa IS, Cuff T, Pauly MP, Shlager L, Palitz AM, Zhao WK, et al. Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. JNCI: J Natl Cancer Inst. 2007;99(19):1462–70.CrossRefPubMed

Spada C, Pasha SF, Gross SA, Leighton JA, Schnoll-Sussman F, Correale L, Gonzalez Suarez B, Costamagna G, Hassan C. Accuracy of first- and second-generation Colon capsules in endoscopic detection of colorectal polyps: a systematic review and meta-analysis. Clin Gastroenterol Hepatol: Offic Clin Pract J Am Gastroenterol Assoc. 2016;14(11):1533–1543.e1538.CrossRef

Rasmussen M. Dansk tarmkræftscreeningsdatabase årsrapport 2015. In: København: Dansk tarmkræftscreeningsdatabase (DTS); 2016.

Spada C, Riccioni ME, Hassan C, Petruzziello L, Cesaro P, Costamagna G. PillCam colon capsule endoscopy: a prospective, randomized trial comparing two regimens of preparation. J Clin Gastroenterol. 2011;45(2):119–24.CrossRefPubMed

10.

Spada C, Hassan C, Ingrosso M, Repici A, Riccioni ME, Pennazio M, Pirozzi GA, Pagano N, Cesaro P, Spera G, et al. A new regimen of bowel preparation for PillCam colon capsule endoscopy: a pilot study. Dig Liver Dis : Offic J Italian Soc Gastroenterol Italian Assoc Stud Liver. 2011;43(4):300–4.CrossRef

11.

Hartmann D, Keuchel M, Philipper M, Gralnek IM, Jakobs R, Hagenmuller F, Neuhaus H, Riemann JF. A pilot study evaluating a new low-volume colon cleansing procedure for capsule colonoscopy. Endoscopy. 2012;44(5):482–6.CrossRefPubMed

12.

Kakugawa Y, Saito Y, Saito S, Watanabe K, Ohmiya N, Murano M, Oka S, Arakawa T, Goto H, Higuchi K, et al. New reduced volume preparation regimen in colon capsule endoscopy. World J Gastroenterol. 2012;18(17):2092–8.CrossRefPubMedPubMedCentral

13.

Singhal S, Nigar S, Paleti V, Lane D, Duddempudi S. Bowel preparation regimens for colon capsule endoscopy: a review. Ther Adv Gastroenterol. 2014;7(3):115–22.CrossRef

14.

Togashi K, Fujita T, Utano K, Waga E, Katsuki S, Isohata N, Endo S, Lefor AK. Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study. Endosc Int Open. 2015;3(6):E659–61.CrossRefPubMedPubMedCentral

15.

Apostolopoulos P, Kalantzis C, Gralnek IM, Liatsos C, Tsironis C, Kalantzis N. Clinical trial: effectiveness of chewing-gum in accelerating capsule endoscopy transit time--a prospective randomized, controlled pilot study. Aliment Pharmacol Ther. 2008;28(4):405–11.CrossRefPubMed

16.

Ho YM, Smith SR, Pockney P, Lim P, Attia J. A meta-analysis on the effect of sham feeding following colectomy: should gum chewing be included in enhanced recovery after surgery protocols? Dis Colon Rectum. 2014;57(1):115–26.CrossRefPubMed

17.

Muller SA, Rahbari NN, Schneider F, Warschkow R, Simon T, von Frankenberg M, Bork U, Weitz J, Schmied BM, Buchler MW. Randomized clinical trial on the effect of coffee on postoperative ileus following elective colectomy. Br J Surg. 2012;99(11):1530–8.CrossRefPubMed

18.

Kobaek-Larsen M, Kroijer R, Dyrvig AK, Buijs MM, Steele RJC, Qvist N, Baatrup G. Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals. Color Dis. 2018; 20(6):479–85. https://doi.org/10.1111/codi.13965.

19.

Leighton JA, Rex DK. A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. Endoscopy. 2011;43(2):123–7.CrossRefPubMed

20.

Giorgi Rossi P. Screening: the information individuals need to support their decision: per protocol analysis is better than intention-to-treat analysis at quantifying potential benefits and harms of screening. BMC medical ethics. 2014;15:28.CrossRefPubMedPubMedCentral

21.

Ou G, Svarta S, Chan C, Galorport C, Qian H, Enns R. The effect of chewing gum on small-bowel transit time in capsule endoscopy: a prospective, randomized trial. Gastrointest Endosc. 2014;79(4):630–6.CrossRefPubMed

22.

Brown SR, Cann PA, Read NW. Effect of coffee on distal colon function. Gut. 1990;31(4):450–3.CrossRefPubMedPubMedCentral

23.

Dulskas A, Klimovskij M, Vitkauskiene M, Samalavicius NE. Effect of coffee on the length of postoperative ileus after elective laparoscopic left-sided colectomy: a randomized, prospective single-center study. Dis Colon Rectum. 2015;58(11):1064–9.CrossRefPubMed

24.

Gungorduk K, Ozdemir IA, Gungorduk O, Gulseren V, Gokcu M, Sanci M. Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial. Am J Obstet Gynecol. 2017;216(2):145.e141–7.CrossRef

25.

Liu Q, Jiang H, Xu D, Jin J. Effect of gum chewing on ameliorating ileus following colorectal surgery: a meta-analysis of 18 randomized controlled trials. Int J Surg (London, England). 2017;47:107–15.CrossRef

Title: Can coffee or chewing gum decrease transit times in Colon capsule endoscopy? A randomized controlled trial
Authors: Maria Magdalena Buijs
Morten Kobaek-Larsen
Lasse Kaalby
Gunnar Baatrup
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Gastroenterology / Issue 1/2018
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/s12876-018-0824-9

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