Saudi Journal of Gastroenterology
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Table of Contents   
LETTER TO EDITOR  
Year : 2015  |  Volume : 21  |  Issue : 1  |  Page : 56
Comment on: Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: A single-blind randomized controlled trial


Department of Gastroenterology, GATA Ankara Training Hospital, Ankara, Turkey

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Date of Web Publication11-Feb-2015
 

How to cite this article:
Sakin YS, Uygun A, Bagci S. Comment on: Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: A single-blind randomized controlled trial. Saudi J Gastroenterol 2015;21:56

How to cite this URL:
Sakin YS, Uygun A, Bagci S. Comment on: Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: A single-blind randomized controlled trial. Saudi J Gastroenterol [serial online] 2015 [cited 2019 Nov 13];21:56. Available from: http://www.saudijgastro.com/text.asp?2015/21/1/56/151233


Sir,

We read with great interest the recently published article by Ergül et al. [1] They aimed to show the beneficial effect of chewing gum on colonoscopy preparation and found enhancement in bowel preparation quality with gum chewing. We thank Ergul et al. for this valuable evaluation, but there are several issues that need to be clarified for a better understanding of the results presented in the authors' report.

The authors found more effective cleaning with sugarless gum in their study. But the ingredients of the gums used were not defined. Most of the sugarless gums contain sweeteners such as sorbitol, xylitol, and aspartame. Sorbitol is poorly absorbed by the gut, and as such acts as an osmotic agent. Sorbitol has been shown to induce osmotic diarrhea at high doses, but its effect at low doses is still controversial. [2],[3] Sorbitol, even in low doses, might have additive effect on bowel cleaning. Although there are different sweeteners in chewing gums, most of them still contain sorbitol in Turkey where the study originated. Thus, in this study the ingredient of the gum could have been mentioned.

Although chewing gum is a cheaper and simple method, which can be used before colonoscopy preparation, but the value of utilizing this must be interpreted with caution until the ingredients of the gum are further clarified.

 
   References Top

1.
Ergül B, Filik L, Koçak E, Doðan Z, Sarýkaya M. Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: A single-blind randomized controlled trial. Saudi J Gastroenterol 2014;20:356-9.  Back to cited text no. 1
    
2.
Bauditz J, Norman K, Biering H, Lochs H, Pirlich M. Severe weight loss caused by chewing gum. BMJ 2008;336:96-7.  Back to cited text no. 2
    
3.
Goldberg LD, Ditchek NT. Chewing gum diarrhea. Am J Dig Dis 1978;23:568.  Back to cited text no. 3
    

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Correspondence Address:
Yusuf Serdar Sakin
Department of Gastroenterology, GATA Ankara Training Hospital, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.151233

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