Clinical trial · Interventional
Impact of Chewing Gum on Bowel Preparation in Patients Undergoing Colonoscopy
Impact of Chewing Gum on Bowel Preparation Quality and Tolerance in Patients Undergoing Colonoscopy With Split-Dose Bowel Preparation: A Randomized Controlled Trial
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Colorectal cancer is the second leading cause of cancer deaths that could be prevented in the United States. Colonoscopy is the best test for finding and removing polyps before they turn into cancer. However, many people are hesitant to have a colonoscopy because of the bowel preparation. The preparation can be difficult to tolerate, with patients often struggling to finish it due to the taste, volume, or side effects like nausea and bloating. This can lead to incomplete procedures or discourage people from getting screened at all. Chewing sugar-free gum is a simple, low-cost, and safe intervention that may make the preparation process easier. One study from China found that chewing gum did not change the quality of bowel cleansing, but patients reported that they were more satisfied with the process. No U.S.-based studies have tested this strategy, and no prior research has looked at whether gum chewing has different effects in people using high-volume versus low-volume prep solutions. The investigators will randomize 160 participants to the stated intervention or control using computer-generated 1:1 randomization. Upon completing the study, the investigators will analyze the data. By studying gum chewing during bowel preparation, the investigators hope to find out whether this small change can make bowel prep more tolerable and encourage more patients to complete their colonoscopy. If successful, this approach could help more people get screened, leading to earlier detection and prevention of colorectal cancer in the community.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Colon Cancer Screening | — | UNRESOLVED | — |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Chewing Sugar-Free Gum During Bowel Preparation | Behavioral | — | UNRESOLVED |
| Standard Bowel Prep | Other | — | UNRESOLVED |
| Standard Bowel Prep (2L PEG-ELP) | Other | — | UNRESOLVED |
Design
Arms and outcomes
Arms (4)
- type
- EXPERIMENTAL
- label
- Chewing Gum During Bowel Preparation (2L PEG-ELP)
- description
- Participants randomized to the experimental arm will chew one piece of sugar-free gum for approximately 15-20 minutes, 30 minutes before starting the first dose of split-dose bowel preparation and again 30 minutes after the second dose. The gum is sugar-free and non-medicated. Participants will be instructed not to swallow the gum and to discontinue chewing if they experience discomfort. All participants will receive standard bowel preparation (either 4L PEG or 2L PEG + ascorbate, prescribed according to clinical indication). The endoscopist performing the colonoscopy will remain blinded to group assignment.
- interventionNames
- Behavioral: Chewing Sugar-Free Gum During Bowel Preparation
- Other: Standard Bowel Prep (2L PEG-ELP)
- type
- ACTIVE_COMPARATOR
- label
- Standard Bowel Preparation 4L (No Gum)
- description
- Participants in the control arm will undergo standard split-dose bowel preparation (4L PEG) according to clinical indication, without chewing gum before or after the preparation. Endoscopists will be blinded to participant group assignment.
- interventionNames
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 45 Years
- Maximum age
- 75 Years
Show eligibility criteria text
Inclusion Criteria: * Age 45-75 years * Scheduled for elective outpatient colonoscopy * Able to provide informed consent Exclusion Criteria: * Prior major abdominal surgery (excluding appendectomy or cholecystectomy) * Pregnancy * Cognitive impairment * Ward of the state * Known allergy to PEG or gum components * Current use of GI prokinetics * Known temporomandibular joint (TMJ) disorder or difficulty chewing/swallowing
References
Publications (5)
- RESULTJohnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, Robertson DJ, Boland CR, Giardello FM, Lieberman DA, Levin TR, Rex DK. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the U.S. multi-society task force on colorectal cancer. Gastrointest Endosc. 2014 Oct;80(4):543-562. doi: 10.1016/j.gie.2014.08.002. No abstract available. PMID 25220509
- RESULTGao C, Zou D, Wang W, Li Y, Han J, Su D, Qi X. Effect of chewing gum combined with WeChat-enhanced instruction on bowel preparation in constipated patients: a randomized-controlled trial. Gastroenterol Rep (Oxf). 2025 Apr 28;13:goaf034. doi: 10.1093/gastro/goaf034. eCollection 2025. PMID 40297539
- RESULTGuo T, et al. Chewing gum improves tolerance but not quality of bowel preparation: a systematic review and meta-analysis. World J Gastrointest Endosc. 2024;16(6):321-333.
- RESULTAtalay R, et al. Gum chewing improves bowel preparation quality for colonoscopy: a randomized trial. Turk J Gastroenterol. 2019;30(9):801-807.
- RESULTZhang S, et al. Effect of chewing gum on bowel preparation before colonoscopy: a randomized controlled trial. Dis Colon Rectum. 2019;62(7):874-881.