Effect of gum chewing or walking exercise on the quality of bowel preparation and patient satisfaction compared to standard preparation before colonoscopy

Introduction: Adequate bowel preparation improves the diagnostic accuracy of colonoscopy by providing clear visualization of the bowel, reduces complications and increases patient satisfaction. Chewing gum and walking exercise have been proven to increase postoperative bowel motility in several studies. However, studies examining the effect of these interventions on bowel preparation before colonoscopy are limited. Aim: The aim of this study was to evaluate the effect of gum chewing or walking exercise on the quality of bowel preparation and patient satisfaction compared to standard preparation before colonoscopy. Method: The data of this single-blind randomized controlled study were collected between July 2024 and December 2024 in the endoscopy unit of a training and research hospital located in the northwestern region of Turkey. A total of 168 patients were divided into three groups: control (n=56), gum chewing (n=56) and walking exercise (n=56). Patients in the control group followed the standard bowel preparation protocol. Patients in the gum chewing group were asked to chew gum for 20 minutes each at specified times before the procedure and patients in the walking exercise group were asked to walk at least 3000 steps until one hour before colonoscopy. Data were collected with the "Descriptive Characteristics Form", "Boston Bowel Preparation Scale" and "Intervention Group Follow-up Form". Descriptive statistics, independent sample t-test, one-way ANOVA, chi-square test and correlation analysis were used for statistical analysis of the data. Results: The adequacy of bowel preparation and cecal intubation rates were statistically significantly higher in the intervention groups compared to the control group (p<0.05). There was no significant difference between the gum chewing and walking exercise groups in terms of these variables. There was no significant difference between the three groups in terms of cecal intubation time, withdrawal time, colonoscopy procedure time and adenoma detection rates (p>0.05). In addition, patients in the intervention groups had significantly higher satisfaction levels after colonoscopy compared to the control group (p<0.001). Conclusion: Both interventions were found to improve the quality of colonoscopy bowel preparation and patient satisfaction. It was also determined that both interventions had similar effects.