Navigating the world of pre-procedure dietary restrictions can be confusing. This article explores the role of chewing gum within the context of clear liquid diets, particularly concerning colonoscopies and surgeries, drawing on research and expert opinions to provide clarity.
The Importance of Clear Liquid Diets Before Medical Procedures
Before undergoing certain medical procedures, such as colonoscopies or surgeries requiring anesthesia, patients are often instructed to follow a clear liquid diet. Clear liquids are defined as those you can see through when held up to the light, such as broth, clear juices, and gelatin. The purpose of this dietary restriction is to ensure the stomach and bowels are empty.
- For Colonoscopies: A clean colon is essential for accurate detection of polyps and other abnormalities. Undigested food can obscure the view and hinder the effectiveness of the procedure. Preparation involves following a clear liquid diet and taking bowel cleansing medications as directed.
- For Surgeries Involving Anesthesia: Avoiding food and drink before surgery helps prevent complications while under anesthesia. A full stomach increases the risk of aspiration, where stomach contents enter the lungs, potentially leading to aspiration pneumonia.
The Chewing Gum Question
A common question that arises during these periods of dietary restriction is whether chewing gum is permissible. The answer, like many things in medicine, isn't always straightforward.
Chewing Gum Before Colonoscopy
Generally, gastroenterology specialists advise against chewing gum before a colonoscopy. Chewing gum can stimulate saliva and gastric juice production, potentially leaving the stomach not empty. Dr. Yuriy Israel, a gastroenterology specialist at Gastroenterology and Nutrition, P.C., explains that an empty stomach is crucial to prevent stomach contents from entering the lungs during sedation, which can lead to aspiration pneumonia.
Chewing Gum Before Surgery
Research on the effects of chewing gum before surgery presents a more nuanced picture. A study published on October 12, 2014, investigated the impact of chewing gum on gastric volume in patients undergoing gastrointestinal endoscopic procedures. In the study, 67 patients scheduled to undergo gastrointestinal endoscopic procedures were randomly divided into two groups. Thirty-four patients were allowed to chew gum until just before the start of their procedure, while 33 patients continued to follow the recommended fasting guidelines. There was no limit on the type, number of gums chewed, or duration of chewing. The study found that the mean gastric volume, or total amount of liquid in the stomach, was statistically higher in patients who chewed gum before their procedure (13ml) versus those who did not (6ml).
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However, the study's lead author, Dr., stated, “While we wouldn’t actively encourage gum chewing in patients presenting for procedures involving anesthesia, in the absence of other aspiration risk factors, patients who inadvertently chew gum should not face cancellation or delay of a surgery or procedure with anesthesia".
Chewing Gum to Improve Bowel Preparation
Interestingly, some research suggests that chewing gum might have a positive impact on the colonoscopy preparation process itself. A recent study in Seoul, South Korea, led by Jisun Lee, R.N., and colleagues, found that chewing gum could help alleviate the undesirable side effects of colonoscopy prep. The gum-chewing group had significantly fewer complaints of nausea, abdominal discomfort, vomiting, and bloating.
However, another study indicated that gum chewing does not improve the quality of bowel preparation for colonoscopy, but it can improve patients' satisfaction with the process of bowel preparation and does not have negative effects on cleanliness. In this study, patients in the gum group chewed sugar-free gum every 2 hours for 20 minutes each time from the end of drinking 2 L of PEG to the beginning of colonoscopy. Patients in the control group only received 2 L of PEG before colonoscopy. More than 90% of patients in both groups were satisfied with the process of bowel preparation, and the incidence of adverse events was comparable in the 2 groups.
Practical Tips for Colonoscopy Preparation
Regardless of the chewing gum debate, proper preparation is key to a successful colonoscopy. Here are some practical tips to ensure a smooth process:
- Follow Dietary Instructions: Adhere strictly to the clear liquid diet in the days leading up to the procedure.
- Take Bowel Prep as Directed: It is VITALLY IMPORTANT to take the prep medications exactly as prescribed by your doctor.
- Expect Frequent Bowel Movements: Be prepared for frequent bowel movements during the bowel preparation phase.
- Stay Hydrated: The bowel prep can be dehydrating, so drink plenty of clear liquids.
- Medication Adjustments: Follow instructions regarding any necessary adjustments to your regular medications, such as anti-inflammatories or blood thinners.
- Post-Procedure Care: After the colonoscopy, follow any post-procedure instructions provided by your doctor. You may resume your regular diet as instructed by your doctor.
Understanding the Colonoscopy Procedure
The colonoscopy itself is a relatively quick procedure, usually taking around 15 to 30 minutes, though patients should allow for a total of three hours at the endoscopy center. During the procedure, patients are usually sedated to minimize discomfort. Digestive Care Center offers Propofol sedation to patients through Anesthesia Care Associates for all endoscopic procedures. Propofol offers many advantages as a sedative for endoscopy. A colonoscopy is a medical procedure that allows doctors to examine the inner lining of the large intestine (colon) and rectum using a flexible tube with a camera attached, known as a colonoscope. This procedure is for detecting and preventing colorectal cancer. It can identify abnormalities such as polyps, which are precancerous growths, and tumors.
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Immediately following your procedure, your physician will have a brief discussion with you about findings during the procedure. However, biopsy results will not be known until the tissue specimens have been examined by a lab facility and sent back to the physician for interpretation.
Choosing a Qualified Gastroenterologist
The expertise of the physician performing the colonoscopy is crucial. The physicians of Digestive Care Center are from various parts of the United States and are all board certified in Gastroenterology, having accumulated at least six years of training after medical school. The gastroenterology training experience is far more intense than that undertaken by general surgeons, internists, or family practitioners that decide to add endoscopy to their practices. These physicians are trained to interpret and treat the conditions they identify and uphold the safest level of endoscopy. This expertise and extensive training is not always present in hospital-based endoscopy and therefore they cannot provide the same level of quality and safety that Digestive Care Center provides.
Navigating Insurance Coverage
Insurance coverage for colonoscopies can vary. Insurance companies often provide screening coverage for screening colonoscopy. However, if during the course of your screening the physician removes a polyp or performs a tissue biopsy, the procedure may be considered diagnostic and may not qualify for coverage as a screening service. In this case, you may be responsible for all or part of the procedure cost. Pre-certification is performed as a courtesy to you in arranging for your procedure and is never a guarantee of coverage.
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