Journal Article

Evaluation of Different Bowel Preparations for Small Bowel Capsule Endoscopy: A Prospective, Randomized, Controlled Study

Valle Muñoz, Julio, Pérez Grueso, Maria Jose, González Asanza, Cecilia, Llach Vila, Jose, Mata Bilbao, Alfredo, Sala Felis, Teresa, Espinós Pérez, Jorge Carlos, Menchen Fernández-Pacheco, Pedro, González Suárez, Begoña, Fernández-Urién, Iñaqui, Ramírez Armengol, Juan Andrés, Muñoz-Navas, Miguel, Pons Beltrán, Vicente, Fernández Diez, Servando, Pérez-Cuadrado, Enrique, Carballo Alvarez, Fernando, Argüello Viudez, Lidia, Balanzó Tintoré, Joaquin

2011

Overview

Background and Study Aims To obtain an adequate view of the whole small intestine during capsule endoscopy (CE) a clear liquid diet and overnight fasting is recommended. However, intestinal content can hamper vision in spite of these measures. Our aim was to evaluate tolerance and degree of intestinal cleanliness during CE following three types of bowel preparation. Patients and Methods This was a prospective, multicenter, randomized, controlled study. Two-hundred ninety-one patients underwent one of the following preparations: 4 L of clear liquids (CL) (group A; 92 patients); 90 mL of aqueous sodium phosphate (group B; 89 patients); or 4 L of a polyethylene glycol electrolyte solution (group C; 92 patients). The degree of cleanliness of the small bowel was classified by blinded examiners according to four categories (excellent, good, fair or poor). The degree of patient satisfaction, gastric and small bowel transit times, and diagnostic yield were measured. Results The degree of cleanliness did not differ significantly between the groups ( P  = 0.496). Interobserver concordance was fair ( k  = 0.38). No significant differences were detected between the diagnostic yields of the CE ( P  = 0.601). Gastric transit time was 35.7 ± 3.7 min (group A), 46.1 ± 8.6 min (group B) and 34.6 ± 5.0 min (group C) ( P  = 0.417). Small-intestinal transit time was 276.9 ± 10.7 min (group A), 249.7 ± 13.1 min (group B) and 245.6 ± 11.6 min (group C) ( P  = 0.120). CL was the best tolerated preparation. Compliance with the bowel preparation regimen was lowest in group C ( P  = 0.008). Conclusions A clear liquid diet and overnight fasting is sufficient to achieve an adequate level of cleanliness and is better tolerated by patients than other forms of preparation.

• Publisher: Springer US,Springer,Springer Nature B.V
• Subject: Biochemistry / Biological and medical sciences / Capsule Endoscopy - methods / Cathartics - pharmacology / Digestive system. Abdomen / Electrolytes - pharmacology / Endoscopy / Fasting / Feeding. Feeding behavior / Female / Fundamental and applied biological sciences. Psychology / Gastroenterology / Gastrointestinal Transit - drug effects / Hepatology / Humans / Intestine, Small - pathology / Investigative techniques, diagnostic techniques (general aspects) / Male / Medical sciences / Medicine / Medicine & Public Health / Middle Aged / Oncology / Original Article / Patient Satisfaction / Phosphates / Phosphates - pharmacology / Polyethylene glycol / Polyethylene Glycols - pharmacology / Polyols / Prospective Studies / Time Factors / Transplant Surgery / Vertebrates: anatomy and physiology, studies on body, several organs or systems