Hard-Candy Consumption Does Not Have an Effect on Volume and pH of Gastric Content in Patients Undergoing Elective Gastrointestinal Endoscopic Procedures: A Randomized Controlled Trial

Figures & data

Table 1 Patient Characteristics, Proton-Pump Inhibitor Use, Indications for Endoscopy, Procedural Time, and Total Anesthesia Time

Variables	Candy (n = 54)	Control (n = 54)	P value
Age (yr) (mean, SD)	59.7 (7.9)	55.8 (10.7)	0.059
Gender (n, %)			0.069
Male	24 (44.4)	14 (25.9)
Female	30 (55.6)	40 (74.1)
Body weight (kg) (mean, SD)	62.1 (11.9)	59.5 (11.1)	0.247
BMI (kg/m^2) (mean, SD)	23.5 (3.4)	23.2 (3.6)	0.628
ASA classification (n, %)			0.362
I	5 (9.3)	10 (18.5)
II	40 (74.1)	37 (64.9)
III	9 (16.7)	7 (12.9)
Underlying diseases (n, %)
Hypertension	18 (33.3)	17 (31.5)	1.000
Diabetes mellitus type 2	8 (14.8)	9 (16.7)	1.000
Dyslipidemia	23 (42.6)	14 (25.9)	0.104
Coronary artery disease	5 (9.3)	1 (1.9)	0.205
Chronic kidney disease	5 (9.3)	2 (3.7)	0.437
Previous stroke	3 (5.6)	3 (5.6)	1.000
Others	30 (55.6)	34 (63.0)	0.557
Proton-pump inhibitor use (n, %)			0.557
No	30 (55.6)	34 (62.9)
Yes	24 (44.4)	20 (37.0)
NPO time (h) (median, IQR)	11 (5–14)	11 (4–14)	0.912
Indications for endoscopy (n, %)
Gastroesophageal reflux disease	8 (14.8)	9 (16.7)	1.000
Dyspepsia	12 (22.2)	13 (24.1)	1.000
Abdominal pain	5 (9.3)	6 (11.1)	1.000
Gastric mass	0	1 (1.9)	1.000
Bowel habit change	4 (7.4)	4 (7.4)	1.000
Chronic diarrhea	0	3 (5.6)	1.000
Weight loss	7 (12.9)	3 (5.6)	0.320
Lower gastrointestinal bleeding	6 (11.1)	3 (5.6)	0.489
Anemia	11 (20.4)	11 (20.4)	1.000
Constipation	2 (3.7)	2 (3.7)	1.000
Colorectal cancer screening	13 (24.1)	12 (22.2)	1.000
Others	15 (27.8)	11 (20.4)	0.500
Procedural time (min) (median, IQR)
EGD	11 (9–15)	11 (7–15)	0.219
Colonoscopy	31 (20–43)	24 (18–34)	0.058
Total anesthesia time (min) (median, IQR)	55 (45–70)	47 (40–60)	0.018*

Notes: Parametric data are presented as n (%) or mean (SD) and compared using Student’s unpaired t-test. Non-parametric data are presented as median (interquartile range) and compared using Mann–Whitney U-test. P value < 0.05 is considered statistically significant. * Indicated P value < 0.05.

Abbreviations: BMI, body mass index; ASA, American Society of Anesthesiologists; NPO, nothing per oral; IQR, interquartile range; EGD, esophagogastroduodenoscopy.

Figure 1 Flow diagram.

Table 2 Patients’ Gastric Volume and pH

Variables	Candy (n = 54)	Control (n = 54)	P value	Median Difference (95% CI)
Gastric volume (mL)	28.5 (15.0–38.0)	20.0 (11.0–32.0)	0.037*	6.00 (0.00–13.00)
Gastric volume (mL/kg)	0.4 (0.3–0.7)	0.3 (0.2–0.6)	0.120	0.08 (−0.02–0.19)
Gastric pH	1.40 (1.10–1.70)	1.40 (1.20–1.90)	0.739	0.00 (−0.20–0.10)

Notes: The data are presented as median (interquartile range) and compared using Mann–Whitney U-test. P value < 0.05 is considered statistically significant. *Indicated P value < 0.05.

Abbreviation: CI, confidence interval.

Table 3 The Impact of Proton-Pump Inhibitor on Gastric pH

Proton-Pump Inhibitor	n	Gastric pH	P value	Subgroup Analysis			P value
				Group	n	Gastric pH
Yes	44	1.6 (1.3–2.7)	0.012*	Candy	24	1.5 (1.3–2.3)	0.363
				Control	20	1.6 (1.3–2.8)
No	64	1.3 (1.1–1.7)		Candy	30	1.3 (1.1–1.6)	0.909
				Control	34	1.3 (1.1–1.7)

Notes: The data are presented as median (interquartile range) and compared using Mann–Whitney U-test. P value < 0.05 is considered statistically significant. *Indicated P value < 0.05.

Abbreviation: PPI, Proton-pump inhibitor.

Table 4 Complications, Difficulty of Procedure, and Endoscopist and Patient Satisfaction

Variables	Candy (n = 54)	Control (n = 54)	P value
Difficulty of procedure (n, %)			0.013*
Very easy	26 (48.1)	40 (74.1)
Easy	24 (44.4)	10 (18.5)
Moderate	4 (7.4)	4 (7.4)
Endoscopist satisfaction (median, IQR)	5 (5–5)	5 (5–5)	0.542
Somewhat satisfied (n, %)	7 (13.0)	5 (9.3)	0.761
Very satisfied (n, %)	47 (87.0)	49 (90.7)
Patient satisfaction (median, IQR)	5 (5–5)	5 (5–5)	0.416
Somewhat dissatisfied (n, %)	0	1 (1.9)	0.386
Neither satisfied nor dissatisfied (n, %)	1 (1.9)	0
Somewhat satisfied (n, %)	3 (5.6)	1 (1.9)
Very satisfied (n, %)	50 (92.6)	52 (96.3)

Notes: Parametric data are presented as n (%) and compared using Student’s unpaired t-test. Non-parametric data are presented as median (interquartile range) and compared using Mann–Whitney U-test. P value < 0.05 is considered statistically significant. Satisfaction scores: 1 very dissatisfied, 2 somewhat dissatisfied, 3 neither satisfied nor dissatisfied, 4 somewhat satisfied, 5 very satisfied. * Indicated P value< 0.05.