ColonoscopyNCT06192394
Effect of Gum Chewing or Walking on Bowel Prep Quality and Patient Satisfaction Before Colonoscopy
A study testing Chewing Gum and Walking Exercise in people with Colonoscopy and Bowel Preparation, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).
Trial summary
Colorectal cancers are a major global health problem, highlighting the critical importance of screening programs for early diagnosis and effective treatment. The success of colonoscopy largely depends on the quality of bowel preparation. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Colonoscopy, Bowel Preparation
- What is being tested?
- Chewing Gum and Walking Exercise
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 168 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 5 Jul 2024to 20 Jul 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Individuals aged between 18 and 65 years,
- Capable of effective communication,
- Mentally healthy,
- Individuals who can comprehend and implement planned interventions before colonoscopy.
Who cannot join
- Individuals with a history of abdominal surgery,
- Those with serious illnesses that could affect the study outcomes (e.g., severe heart failure, kidney failure),
- Individuals using medications that could impact intestinal functions due to systemic diseases,
- Individuals who have not complied with the recommended interventions will not be included.
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Istanbul University-Cerrahpaşa
Istanbul, 34000
About this study
Official title: Effect of Gum Chewing or Walking Exercise on the Quality of Bowel Preparation and Patient Satisfaction Compared to Standard Preparation Before Colonoscopy
Colorectal cancers are a major global health problem, highlighting the critical importance of screening programs for early diagnosis and effective treatment. The success of colonoscopy largely depends on the quality of bowel preparation. Inadequate bowel preparation may reduce the effectiveness of colonoscopy and cause lesions to be missed.
Previous research has shown the positive effects of diet, training, and polyethylene glycol use on bowel readiness. However, there is limited research on the effects of methods such as gum chewing and walking exercise.
Read more
This study aims to evaluate the effects of gum chewing and walking exercise, as well as diet and medication, on the quality of bowel preparation and patient satisfaction during the bowel preparation process before colonoscopy. The study uses a randomized controlled, single-blind experimental design with three different groups: a control group, a gum chewing group, and a walking exercise group. Each group will be evaluated based on bowel preparation quality and patient satisfaction. The quality of bowel preparation will be determined using the Boston Bowel Preparation Scale, and factors such as polyp detection, workability of colonoscopy, and cecal intubation time will also be evaluated. Patient satisfaction levels will be evaluated by taking into account how satisfied the patients are with the colonoscopy procedure and their complaints before and after the procedure.
The results of this study will contribute to a better understanding of the impact of chewing gum and walking exercise before colonoscopy on the quality of bowel preparation and patient satisfaction. Identifying effective methods to improve the quality of bowel preparation can contribute to a healthier society by raising the standard of nursing care. At the same time, this research may improve the comfort and effectiveness of the colonoscopy process for patients and benefit public health by increasing the effectiveness of colorectal cancer screening programs.
Read the detailed description
An ideal bowel preparation should have the capacity to evacuate the fecal load quickly, without compromising the comfort of patients or causing fluid-electrolyte imbalance. Various methods are used to improve the quality of bowel preparation, such as pre-colonoscopy education, low-fiber diet, and use of split-dose polyethylene glycol (PEG). There are many scientific studies showing that these methods increase the quality of bowel preparation. However, there have been fewer studies showing that methods such as chewing gum and walking exercises before colonoscopy increase the quality of bowel preparation. No study has been found in which these two methods were evaluated together. In order to eliminate the deficiency in this field, it is thought that this study will be useful in improving the quality of bowel preparation before colonoscopy.
Chewing gum is a virtual feeding method that stimulates the cephalic-vagal reflex, promoting the secretion of gastric and intestinal hormones and increasing intestinal motility. Chewing gum has advantages such as ease of application, low cost, and no reported side effects. Therefore, the use of this method as a safe intervention is recommended. Its effectiveness in reducing postoperative ileus and hospital stay has been demonstrated in many studies.
It is stated that walking exercise improves bowel cleanliness and reduces discomfort associated with nausea and abdominal pain during bowel preparation for colonoscopy. A systematic review found that low and moderate-intensity exercise lasting less than 60 minutes supports gastrointestinal motility.
Inadequate bowel preparation can lead to the repetition of the colonoscopy procedure, negatively affecting patients' experiences and satisfaction. In addition to this, factors such as the difficulty of the bowel preparation process in patients undergoing colonoscopy, unsedated colonoscopy, long appointment dates, and insufficient pre-procedure information can also negatively impact patient satisfaction. Assessing the satisfaction of patients is recommended for a successful and high-quality colonoscopy procedure.
This study was designed as a randomized controlled experimental study to determine the effects of gum chewing and walking exercise, as well as the use of diet and medication during the bowel preparation process before colonoscopy, on the quality of bowel preparation and patient satisfaction.
- Conditions
- Colonoscopy, Bowel Preparation
- Being tested
- Chewing Gum, Walking Exercise, Control
- Keywords
- Colonoscopy, Patient Satisfaction, Chewing Gum, Walking Exercise
- Medical subject headings
- Patient Satisfaction
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Chewing GumOther
Patients will be asked to chew xylitol gum for 20 minutes every 2 hours (17.00-19.00, 19.00-21.00, 21.00-23.00) after drinking the X-M Diet syrup prescribed the day before the colonoscopy procedure. After the enema is given on the day of the colonoscopy, they will be asked to chew gum for 20 minutes every 2 hours until one hour before the scheduled procedure time. Xylitol is a naturally occurring five-carbon sugar alcohol (C5H12O5) found in fruits and vegetables such as plums, strawberries, cauliflower, and pumpkin. It is similar in taste to sucrose but contains 40% fewer calories than other carbohydrates (1 gram of xylitol = 2.4 calories). Xylitol has positive effects on dental health and may also have beneficial impacts on other systems such as immunity, respiratory, and digestive systems. Since xylitol is not digested by human enzymes, it has a laxative effect. In the study, sugar-free gum with xylitol will be used.
Walking ExerciseOther
Patients will be given a pedometer to count their steps and will be asked to walk at least 3000 steps before the colonoscopy procedure.
ControlOther
Patients will undergo standard bowel preparation determined by the hospital.
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Sham comparator | Patients in the control group will undergo the standard bowel preparation determined by the hospital, which includes the following steps:
* No solid food should be consumed after the evening meal 2 days before colonoscopy.
* Only clear liquids should be consumed the day before colonoscopy.
* If the colonoscopy is scheduled for 12:00 PM, nothing should be eaten or drank after midnight on the preceding night; if the colonoscopy is scheduled for the afternoon, nothing should be consumed after 06:00 AM on the same day.
* The entire X-M Diet syrup should be consumed with plenty of water within 1 hour at 4:00 PM and 8:00 PM the day before colonoscopy. Additionally, an enema (BT Enema) should be administered at 11:00 PM the night before and at 07:00 AM on the day of colonoscopy. Receives: Other: Control |
| Chewing Gum Group | Active comparator | All patients in the gum-chewing group will receive the following interventions in addition to standard bowel preparation:
* Patients will be instructed to chew xylitol gum for 20 minutes at three intervals (17:00-19:00, 19:00-21:00, 21:00-23:00) after consuming the prescribed X-M Diet syrup on the day before the procedure.
* Following the administration of an enema on the procedure day, patients will be instructed to chew gum every 2 hours for 20 minutes until one hour before the scheduled procedure time. Receives: Other: Chewing Gum |
| Walking Exercise Group | Active comparator | All patients in the walking group will receive the following interventions in addition to standard bowel preparation:
* Patients will be asked to drink the prescribed X-M diet syrup 1 day before the procedure and then walk for 1 hour at two specific times (from 18:00 to 19:00 and from 22:00 to 23:00).
* On the day of the procedure, after the enema, patients will be instructed to walk from 08:00 until one hour before the scheduled procedure time.
* Patients will be given a pedometer to count their steps and will be asked to walk at least 3000 steps before the colonoscopy procedure. Receives: Other: Walking Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Boston Bowel Preparation Classification (BBPS)
The Boston Bowel Preparation Scale (BBPS) is a rating scale used to evaluate the adequacy of bowel preparation.
Measured: Day of colonoscopy only
Secondary outcomes (1)
Patient satisfaction
The patient's perception of the usefulness of the intervention as self-reported in a preprocedural survey.
Measured: 2 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jan 2024
- Study start5 Jul 2024
- Primary completion30 Dec 2024
- Study completion20 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ColonoscopyStudies of the same condition, open and under way.
- More trials run by Istanbul University - CerrahpasaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- There are three groups: control, gum chewing and walking exercise.
- Masking
- Single blind
- Who is masked
- Care provider
- Enrolment
- 168 participants (actual)
Sponsor and investigators
- Lead sponsor
- Istanbul University - Cerrahpasa
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, ibrahim kiyat, Istanbul University - Cerrahpasa
- Investigators
- ibrahim kiyat, Principal investigator, PhD student
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06192394
- Sponsor's protocol ID
- IUC-HEM-IK-01
- Status last verified
- Jan 2026
- First submitted
- 21 Dec 2023
- Last updated
- 15 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The study data will be shared upon contact with researchers conducting meta-analysis or systematic reviews.
Study at a glance
From the registry record, last updated by the sponsor on 15 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Gum Chewing or Walking Exercise on the Quality of Bowel Preparation and Patient Satisfaction Compared to Standard Preparation Before Colonoscopy
- ClinicalTrials.gov ID
- NCT06192394
- Acronym / sponsor ID
- IUC-HEM-IK-01
- Conditions
- Colonoscopy, Bowel Preparation
- Keywords
- Colonoscopy, Patient Satisfaction, Chewing Gum, Walking Exercise
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 168 participants (actual)
- Lead sponsor
- Istanbul University - CerrahpasaUniversity, hospital or other
- Study start
- 5 Jul 2024 (actual)
- Primary completion
- 30 Dec 2024 (actual)
- Study completion
- 20 Jul 2025 (actual)
- First posted
- 5 Jan 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Colorectal cancers are a major global health problem, highlighting the critical importance of screening programs for early diagnosis and effective treatment. The success of colonoscopy largely depends on the quality of bowel preparation. Inadequate bowel preparation may reduce the effectiveness of colonoscopy and cause lesions to be missed.
Previous research has shown the positive effects of diet, training, and polyethylene glycol use on bowel readiness. However, there is limited research on the effects of methods such as gum chewing and walking exercise.
This study aims to evaluate the effects of gum chewing and walking exercise, as well as diet and medication, on the quality of bowel preparation and patient satisfaction during the bowel preparation process before colonoscopy. The study uses a randomized controlled, single-blind experimental design with three different groups: a control group, a gum chewing group, and a walking exercise group. Each group will be evaluated based on bowel preparation quality and patient satisfaction. The quality of bowel preparation will be determined using the Boston Bowel Preparation Scale, and factors such as polyp detection, workability of colonoscopy, and cecal intubation time will also be evaluated. Patient satisfaction levels will be evaluated by taking into account how satisfied the patients are with the colonoscopy procedure and their complaints before and after the procedure.
The results of this study will contribute to a better understanding of the impact of chewing gum and walking exercise before colonoscopy on the quality of bowel preparation and patient satisfaction. Identifying effective methods to improve the quality of bowel preparation can contribute to a healthier society by raising the standard of nursing care. At the same time, this research may improve the comfort and effectiveness of the colonoscopy process for patients and benefit public health by increasing the effectiveness of colorectal cancer screening programs.
Detailed description
An ideal bowel preparation should have the capacity to evacuate the fecal load quickly, without compromising the comfort of patients or causing fluid-electrolyte imbalance. Various methods are used to improve the quality of bowel preparation, such as pre-colonoscopy education, low-fiber diet, and use of split-dose polyethylene glycol (PEG). There are many scientific studies showing that these methods increase the quality of bowel preparation. However, there have been fewer studies showing that methods such as chewing gum and walking exercises before colonoscopy increase the quality of bowel preparation. No study has been found in which these two methods were evaluated together. In order to eliminate the deficiency in this field, it is thought that this study will be useful in improving the quality of bowel preparation before colonoscopy.
Chewing gum is a virtual feeding method that stimulates the cephalic-vagal reflex, promoting the secretion of gastric and intestinal hormones and increasing intestinal motility. Chewing gum has advantages such as ease of application, low cost, and no reported side effects. Therefore, the use of this method as a safe intervention is recommended. Its effectiveness in reducing postoperative ileus and hospital stay has been demonstrated in many studies.
It is stated that walking exercise improves bowel cleanliness and reduces discomfort associated with nausea and abdominal pain during bowel preparation for colonoscopy. A systematic review found that low and moderate-intensity exercise lasting less than 60 minutes supports gastrointestinal motility.
Inadequate bowel preparation can lead to the repetition of the colonoscopy procedure, negatively affecting patients' experiences and satisfaction. In addition to this, factors such as the difficulty of the bowel preparation process in patients undergoing colonoscopy, unsedated colonoscopy, long appointment dates, and insufficient pre-procedure information can also negatively impact patient satisfaction. Assessing the satisfaction of patients is recommended for a successful and high-quality colonoscopy procedure.
This study was designed as a randomized controlled experimental study to determine the effects of gum chewing and walking exercise, as well as the use of diet and medication during the bowel preparation process before colonoscopy, on the quality of bowel preparation and patient satisfaction.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (care provider)
- Number of arms
- 3
- Model description
- There are three groups: control, gum chewing and walking exercise.
| Arm | Type | Receives |
|---|---|---|
| Control Group | Sham comparator | Other: ControlPatients in the control group will undergo the standard bowel preparation determined by the hospital, which includes the following steps: * No solid food should be consumed after the evening meal 2 days before colonoscopy. * Only clear liquids should be consumed the day before colonoscopy. * If the colonoscopy is scheduled for 12:00 PM, nothing should be eaten or drank after midnight on the preceding night; if the colonoscopy is scheduled for the afternoon, nothing should be consumed after 06:00 AM on the same day. * The entire X-M Diet syrup should be consumed with plenty of water within 1 hour at 4:00 PM and 8:00 PM the day before colonoscopy. Additionally, an enema (BT Enema) should be administered at 11:00 PM the night before and at 07:00 AM on the day of colonoscopy. |
| Chewing Gum Group | Active comparator | Other: Chewing GumAll patients in the gum-chewing group will receive the following interventions in addition to standard bowel preparation: * Patients will be instructed to chew xylitol gum for 20 minutes at three intervals (17:00-19:00, 19:00-21:00, 21:00-23:00) after consuming the prescribed X-M Diet syrup on the day before the procedure. * Following the administration of an enema on the procedure day, patients will be instructed to chew gum every 2 hours for 20 minutes until one hour before the scheduled procedure time. |
| Walking Exercise Group | Active comparator | Other: Walking ExerciseAll patients in the walking group will receive the following interventions in addition to standard bowel preparation: * Patients will be asked to drink the prescribed X-M diet syrup 1 day before the procedure and then walk for 1 hour at two specific times (from 18:00 to 19:00 and from 22:00 to 23:00). * On the day of the procedure, after the enema, patients will be instructed to walk from 08:00 until one hour before the scheduled procedure time. * Patients will be given a pedometer to count their steps and will be asked to walk at least 3000 steps before the colonoscopy procedure. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Individuals aged between 18 and 65 years,
- Capable of effective communication,
- Mentally healthy,
- Individuals who can comprehend and implement planned interventions before colonoscopy.
Key exclusion criteria (4 listed)
- Individuals with a history of abdominal surgery,
- Those with serious illnesses that could affect the study outcomes (e.g., severe heart failure, kidney failure),
- Individuals using medications that could impact intestinal functions due to systemic diseases,
- Individuals who have not complied with the recommended interventions will not be included.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Chewing GumPatients will be asked to chew xylitol gum for 20 minutes every 2 hours (17.00-19.00, 19.00-21.00, 21.00-23.00) after drinking the X-M Diet syrup prescribed the day before the colonoscopy procedure. After the enema is given on the day of the colonoscopy, they will be asked to chew gum for 20 minutes every 2 hours until one hour before the scheduled procedure time. Xylitol is a naturally occurring five-carbon sugar alcohol (C5H12O5) found in fruits and vegetables such as plums, strawberries, cauliflower, and pumpkin. It is similar in taste to sucrose but contains 40% fewer calories than other carbohydrates (1 gram of xylitol = 2.4 calories). Xylitol has positive effects on dental health and may also have beneficial impacts on other systems such as immunity, respiratory, and digestive systems. Since xylitol is not digested by human enzymes, it has a laxative effect. In the study, sugar-free gum with xylitol will be used. | Other | Chewing Gum Group |
| Walking ExercisePatients will be given a pedometer to count their steps and will be asked to walk at least 3000 steps before the colonoscopy procedure. | Other | Walking Exercise Group |
| ControlPatients will undergo standard bowel preparation determined by the hospital. | Other | Control Group |
Primary outcome
Boston Bowel Preparation Classification (BBPS)
Time frame: Day of colonoscopy only
The Boston Bowel Preparation Scale (BBPS) is a rating scale used to evaluate the adequacy of bowel preparation.
1 secondary outcome
Patient satisfaction
Time frame: 2 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jan 2026.
- Individual participant dataSharing planned: No. The study data will be shared upon contact with researchers conducting meta-analysis or systematic reviews.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
ibrahim kiyat principal investigator
PhD student
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Chewing Gum and Walking Exercise in people with Colonoscopy and Bowel Preparation, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Boston Bowel Preparation Classification (BBPS) (time frame: Day of colonoscopy only). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jan 2026; AzTrials last refreshed its copy on 6 Nov 2026.