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Assessing the effect of sugar-free chewing gum use on the residual gastric volume of patients fasting for gastroscopy: A randomised controlled trial


Best, GWJ and Fanning, SB and Robertson, IK and Blackford, D and Mitchell, BL, Assessing the effect of sugar-free chewing gum use on the residual gastric volume of patients fasting for gastroscopy: A randomised controlled trial, Anaesthesia and Intensive Care, 47, (6) pp. 541-547. ISSN 0310-057X (2019) [Refereed Article]

Copyright Statement

Copyright The Author(s) 2019

DOI: doi:10.1177/0310057X19886881


There is no clear consensus in the current guidelines published by major international anaesthetic associations on what is the most appropriate time for a patient to stop chewing gum. This open-label balanced-group randomised controlled trial aimed to evaluate whether the chewing of sugar-free gum caused an increased volume or reduced pH of residual gastric fluid in fasting patients. For this study 212 patients undergoing elective gastroscopy were randomised into a control group who followed routine fasting instructions and an intervention group who were asked to chew gum while fasting. Residual gastric fluid was aspirated under direct vision via a gastroscope under anaesthesia. The primary outcome was the incidence of a gastric residual volume >50 ml in participants who chewed gum compared with a control group. Secondary outcomes were variability in the overall gastric volume distribution and gastric pH distribution between the two groups. Nine out of 110 (8.2%) in the chewing gum group and six out of 102 (5.9%) in the control group had a residual gastric fluid volume >50 ml: incidence rate ratio 1.39 (95% confidence intervals (CI) 0.513.77; P = 0.60). However, only one patient (in the control group) had a residual gastric volume >73 ml. There was no statistically significant difference in gastric volume distribution between groups, odds ratio 1.60 (95% CI 0.992.58; P = 0.054) or in the distribution of gastric pH measurement, odds ratio 0.90 (95% CI 0.571.44; P = 0.67). These results indicate that if there is an increase in the incidence of residual gastric volume >50 ml in patients who chew gum preoperatively, it is likely to be small. Moreover, the absence of any patients in our chewing gum group with a residual gastric volume >73 ml is reassuring.

Item Details

Item Type:Refereed Article
Keywords:chewing gum, fasting guidelines, gastroscopic suctioning, pulmonary aspiration, residual gastric volume
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Surgery
Objective Division:Expanding Knowledge
Objective Group:Expanding knowledge
Objective Field:Expanding knowledge in the health sciences
UTAS Author:Robertson, IK (Dr Iain Robertson)
ID Code:136790
Year Published:2019
Web of Science® Times Cited:2
Deposited By:Health Sciences
Deposited On:2020-01-17
Last Modified:2020-04-28

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