Effectiveness of Improved Use of Chewing Gum During Capsule Endoscopy in Decreasing Gastric Transit Time: A Prospective Randomized Controlled Study.
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SUBMITTER: Huang L
PROVIDER: S-EPMC7928368 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: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.
| S-EPMC6020226 | biostudies-literature
Project description:Background and study aims Determining the etiology and location of gastrointestinal motility disorders can be challenging. A range of investigations targeting specific areas of gastrointestinal transit are available, but many provide clinical data for a given gastrointestinal region alone or for non-specific whole gut transit, and are otherwise of limited use. Video capsule endoscopy allows endoscopic visualisation of the entire gastrointestinal tract, and may also provide more specific data for regional transit time abnormalities. Patients and methods Data from video capsules ingested by 71 ambulatory healthy subjects were recorded and analyzed to determine gastric and small bowel transit times in the fasting state. Results Median, and interquartile range (IQR), gastric transit time was 22 (10-48) minutes, and median (IQR) small bowel transit time was 198.5 (157-240.5) minutes. Conclusion These data, for the first time to our knowledge, provide references for gastrointestinal transit times among healthy ambulatory subjects using video capsule endoscopy. This potentially strengthens clinical use of video capsule endoscopy in the investigation of patients with suspected gastrointestinal motility disorders.
| S-EPMC7035031 | biostudies-literature
Project description:Here we show the bacteriome of wasted chewing gums from five different countries and the microbial successions on wasted gums during three months of outdoors exposure. In addition, a collection of bacterial strains from wasted gums was set, and the biodegradation capability of different gum ingredients by the isolates was tested. Our results reveal that the oral microbiota present in gums after being chewed, characterised by the presence of species such as Streptococcus spp. or Corynebacterium spp., evolves in a few weeks to an environmental bacteriome characterised by the presence of Acinetobacter spp., Sphingomonas spp. and Pseudomonas spp. Wasted chewing gums collected worldwide contain a typical sub-aerial biofilm bacteriome, characterised by species such as Sphingomonas spp., Kocuria spp., Deinococcus spp. and Blastococcus spp. Our findings have implications for a wide range of disciplines, including forensics, contagious disease control, or bioremediation of wasted chewing gum residues.
| S-EPMC7545173 | biostudies-literature
Project description:BackgroundThe complete examination rate of video capsule endoscopy can be increased by reduced gastric transit time (GTT) and or small bowel transit time (SBTT). This study aims to examine whether the prokinetic domperidone reduces GTT and/or SBTT in pediatric patients undergoing video capsule endoscopy (VCE).MethodsWe performed a single-center randomized controlled trial (n=200) to evaluate the effect of domperidone on GTT and SBTT among pediatric patients in a tertiary university-affiliated hospital for children. We explored whether patients randomized to domperidone had increased GTT, SBTT (primary outcomes) or higher complete examination rate (secondary outcome). The safety outcomes were the adverse effects in the domperidone group. This study was registered on ClinicalTrials.gov (NCT03662113).ResultsDemographic features including gender and age were similar between the 100 patients of the domperidone group and the 100 patients of the control group. The median GTT was 67.5 minutes (44.8-117.5) in the domperidone group and 80.0 minutes (42.0-128.0) in the control group, while the median SBTT was 317 minutes (231-436) and 323 minutes (225-426), respectively. There were no significant differences in GTT (P=0.49) and SBTT (P=0.52) between the two groups. The complete examination rate was 97% and 98% in the domperidone and control groups, respectively (P=1.00).ConclusionsDomperidone shows no effect on GTT, SBTT and complete examination rate in pediatric patients receiving VCE.
| S-EPMC7944175 | biostudies-literature
Project description:BackgroundWhile capsule endoscopy (CE) is the gold standard diagnostic method of detecting small bowel (SB) diseases and disorders, a novel magnetically controlled capsule endoscopy (MCCE) system provides non-invasive evaluation of the gastric mucosal surface, which can be performed without sedation or discomfort. During standard SBCE, passive movement of the CE may cause areas of the complex anatomy of the gastric mucosa to remain unexplored, whereas the precision of MCCE capsule movements inside the stomach promises better visualization of the entire mucosa.AimTo evaluate the Ankon MCCE system's feasibility, safety, and diagnostic yield in patients with gastric or SB disorders.MethodsOf outpatients who were referred for SBCE, 284 (male/female: 149/135) were prospectively enrolled and evaluated by MCCE. The stomach was examined in the supine, left, and right lateral decubitus positions without sedation. Next, all patients underwent a complete SBCE study protocol. The gastric mucosa was explored with the Ankon MCCE system with active magnetic control of the capsule endoscope in the stomach, applying three standardized pre-programmed computerized algorithms in combination with manual control of the magnetic movements.ResultsThe urea breath test revealed Helicobacter pylori positivity in 32.7% of patients. The mean gastric and SB transit times with MCCE were 0 h 47 min 40 s and 3 h 46 min 22 s, respectively. The average total time of upper gastrointestinal MCCE examination was 5 h 48 min 35 s. Active magnetic movement of the Ankon capsule through the pylorus was successful in 41.9% of patients. Overall diagnostic yield for detecting abnormalities in the stomach and SB was 81.9% (68.6% minor; 13.3% major pathologies); 25.8% of abnormalities were in the SB; 74.2% were in the stomach. The diagnostic yield for stomach/SB was 55.9%/12.7% for minor and 4.9%/8.4% for major pathologies.ConclusionMCCE is a feasible, safe diagnostic method for evaluating gastric mucosal lesions and is a promising non-invasive screening tool to decrease morbidity and mortality in upper gastro-intestinal diseases.
| S-EPMC9157624 | biostudies-literature
Project description:Background and study aims Colon capsule endoscopy (CCE) has the potential to explore the entire gastrointestinal tract. The aim of this study was to assess the applicability of CCE as pan-endoscopy. Patients and methods Healthy participants received CCE with bowel preparation (bisacodyl, polyethylene electrolyte glycol (PEG) + ascorbic acid) and booster regimen (metoclopramide, oral sulfate solution (OSS)). For each segment of the gastrointestinal tract, the following quality parameters were assessed: cleanliness, transit times, reading times, patient acceptance and safety of the procedure. When all gastrointestinal segments had cleansing score good or excellent, cleanliness of the whole gastrointestinal tract was assessed as good. Participants' expected and perceived burden was assessed by questionnaires and participants were asked to grade the procedure (scale 0-10). All serious adverse events (SAEs) were documented. Results A total of 451 CCE procedures were analyzed. A good cleansing score was achieved in the stomach in 69.6%, in the SB in 99.1 % and in the colon in 76.6 %. Cleanliness of the whole gastrointestinal tract was good in 52.8 % of the participants. CCE median transit time of the whole gastrointestinal tract was 583 minutes IQR 303-659). The capsule reached the descending colon in 94.7 %. Median reading time per procedure was 70 minutes (IQR 57-83). Participants graded the procedure with a 7.8. There were no procedure-related SAEs. Conclusions CCE as pan-endoscopy has shown to be a safe procedure with good patient acceptance. When cleanliness of all gastrointestinal segments per patient, completion rate and reading time will be improved, CCE can be applied as a good non-invasive alternative to evaluate the gastrointestinal tract.
| S-EPMC8670994 | biostudies-literature
Project description:Abstract Background Small bowel capsule endoscopy (CE) has limited recording time and does not visualize the entire length of the small intestine in approximately 16.5% of the cases. We hypothesize that bacon-chewing is potent stimulus of cephalic response, which may reduce capsule transit times and improve complete examination rate (CER). Aims To determine if sham feeding with bacon-chewing improves small bowel transit time and completion rate in patients undergoing capsule endoscopy. Methods A prospective, single-blinded, randomized controlled trial at St. Paul’s Hospital in Vancouver, BC has been recruiting since 01/2015. Inclusion: outpatient CE, age ≥ 19. Exclusion criteria: ongoing use of motility-enhancing or slowing drugs, active bowel obstruction, bowel resection, swallowing disorder, diabetes with end-organ damage, untreated thyroid disorder, and endoscopic placement of capsule camera. Given Imaging PillCam SB3TM (Yoqneam, Israel) were used. Participants were assigned to either bacon or control group via concealed allocation based on unrestricted randomization sequence generated prior to study initiation. All subjects underwent bowel preparation with 2L PEG3350 with electrolytes the day before, and fasted ≥ 2h prior to the procedure. They were allowed to drink clear fluids and resume normal diet 2h and 4h post-capsule ingestion, respectively. Immediately after swallowing the capsule, subjects in the bacon group were asked to chew and spit 10 pieces of bacon, each over 30 seconds at one-minute intervals. This process was repeated an hour after ingesting the capsule. Gastric transit time (GTT), small bowel transit time (SBTT), and CER were compared between the groups. This study was approved by institutional research ethics board and registered on clinicaltrials.gov (NCT02353208). Results Between 01/2015 to 09/2016, 109 CE’s were included in the study, 89 of which were for GI bleeding. CE did not pass the pylorus in four patients in the bacon group during the recording, and were excluded from further transit time analyses. One and two additional CE’s in the control and bacon group, respectively, did not reach cecum during recording and were excluded from SBTT analysis. There was no statistically significant difference in GTT, SBTT, or CER. Conclusions Sham feeding by chewing and spitting bacon does not alter transit times or CER, and therefore should not be used in an attempt to improve CE yield. ResultsControl (n=54)Bacon (n=55)P valueAge (mean ± SD)57.2 ± 15.657.9 ± 17.50.83Female (%)30 (55.6%)30 (54.5%)0.92Charlson Comorbidity Index3.4 ± 2.43.3 ± 2.80.99GTT (minutes)mean ± SDmedian (IQR)41.4 ± 47.224.7 (13.9, 55.7)56.7 ± 126.517.2 (10.3, 68.6)0.20SBTT (minutes)mean ± SDmedian (IQR)230.0 ± 106.2217.6 (157.4, 282.3)223.1 ± 128.5198.5 (119.6, 294.8)0.38CER (%)53 (98.1%)49 (89.1%)0.054 Funding Agencies None
| S-EPMC6507822 | biostudies-literature
Project description:There is some evidence to suggest that chewing gum reduces chronic stress. However, it remains controversial how the taste and odour properties of chewing gum influence stress. The present study was designed to investigate this issue in human subjects. Using an enzyme-linked immunosorbent assay, we tested salivary cortisol concentration, which is thought to be a stress marker, in 96 adults who chewed gum with different combinations of taste and odour. Subjects could discriminate between the types of gum without prior information. Salivary cortisol concentrations were highest and lowest for the subjects who chewed the most flavourful gum and the least flavourful gum, respectively. These findings suggest that the salivary cortisol level during gum chewing is not a marker of negative emotions (i.e., stressful conditions) as traditionally considered but, rather, an index of positive emotions that can facilitate biological responses to overcome stressful conditions.
| S-EPMC5381771 | biostudies-literature
Project description:Visually induced motion sickness (VIMS) is a common side-effect of exposure to virtual reality (VR). Its unpleasant symptoms may limit the acceptance of VR technologies for training or clinical purposes. Mechanical stimulation of the mastoid and diverting attention to pleasant stimuli-like odors or music have been found to ameliorate VIMS. Chewing gum combines both in an easy-to-administer fashion and should thus be an effective countermeasure against VIMS. Our study investigated whether gustatory-motor stimulation by chewing gum leads to a reduction of VIMS symptoms. 77 subjects were assigned to three experimental groups (control, peppermint gum, and ginger gum) and completed a 15-min virtual helicopter flight, using a VR head-mounted display. Before and after VR exposure, we assessed VIMS with the Simulator Sickness Questionnaire (SSQ), and during the virtual flight once every minute with the Fast Motion Sickness Scale (FMS). Chewing gum (peppermint gum: M = 2.44, SD = 2.67; ginger gum: M = 2.57, SD = 3.30) reduced the peak FMS scores by 2.05 (SE = 0.76) points as compared with the control group (M = 4.56, SD = 3.52), p < 0.01, d = 0.65. Additionally, taste ratings correlated slightly negatively with both the SSQ and the peak FMS scores, suggesting that pleasant taste of the chewing gum is associated with less VIMS. Thus, chewing gum may be useful as an affordable, accepted, and easy-to-access way to mitigate VIMS in numerous applications like education or training. Possible mechanisms behind the effect are discussed.
| S-EPMC8741140 | biostudies-literature
Project description:Background and study aims When capsule endoscopy (CE) detects a small bowel (SB) target lesion that may be manageable with enteroscopy, the selection of the insertion route is critical. Time- and progression-based CE indices have been proposed for localization of SB lesions. This systematic review analysed the role of CE transit indicators in choosing the insertion route for double-balloon enteroscopy (DBE). Methods A comprehensive literature search identified papers assessing the role of CE on the choice of the route selection for DBE. Data on CE, criteria for route selection, and DBE success parameters were retrieved and analyzed according to the PRISMA statement. Risk of bias was assessed through the STROBE assessment. The primary outcome evaluated was DBE success rate in reaching a SB lesion, measured as the ratio of positive initial DBE to the number of total DBE. Results Seven studies including 262 CEs requiring subsequent DBE were selected. Six studies used time-based indices and one used the PillCam Progress indicator. SB lesions were identified and insertion route was selected according to a specific cut-off, using fixed landmarks for defining SB transit except for one study in which the mouth-cecum transit was considered. DBE success rate was high in all studies, ranging from 78.3 % to 100 %. Six of seven studies were high quality. Conclusions The precise localization of SB lesions remains an open issue, and larger studies are required to determine the most accurate index for selecting the DBE insertion route. In the future, 3 D localization technologies and tracking systems will be essential to accomplish this tricky task.
| S-EPMC7834922 | biostudies-literature