Abstract
BackgroundA 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).MethodsOne 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.ResultsThe 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.ConclusionsChewing 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 registrationNCT02303756, registered on December 1st 2014.
Highlights
A high rate of complete colon capsule endoscopy (CCE) investigations is required for a more widespread use of CCE
The age of participants was similar in all groups, but there was a trend towards more male participants in the chewing group (77% vs 55 and 63% in respectively the coffee and control group, p = 0.052)
There were no significant differences between the groups, even though the chewing gum had the highest excretion rate of 63% in comparison to coffee (58%; 95% CI: 43–72) and controls (55%; 95% CI: 42–68)
Summary
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). Coffee and chewing gum have been reported to reduce transit time in small bowel capsule endoscopy and after abdominal surgery [15,16,17]. Some clinics already use coffee or chewing gum as part of their CCE bowel preparation, but their effect has not been studied in CCE as yet. The objective of this study was to investigate if addition of either coffee or chewing gum to the standard CCE bowel preparation can increase excretion during battery life time
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