Capsule endoscopy: role of bowel preparation in successful visualization.
BACKGROUND
Lesions of the small bowel that cannot be detected by other techniques can be indentified by capsule endoscopy. Good preparation before any endoscopic procedure is the most important factor for patient safety, quality of care and cost effectiveness. This should also apply to capsule endoscopy. The aim of this study was to evaluate the quality and efficacy of preparation with oral sodium phosphate for capsule endoscopy.


METHODS
A retrospective cohort study design was used. The study sample consisted of 32 consecutive patients scheduled for capsule endoscopy in two periods; the first 10 patients were prepared with overnight fasting only, and the next 22 with oral sodium phosphate. An experienced endoscopist and gastroenterology nurse, who were blinded to the method used, graded the quality of preparation.


RESULTS
Small-bowel cleansing was significantly better in patients given sodium phosphate. Five patients (50%) received a poor preparation rating in the first period compared with only 1 (4.5%) of the 22 patients given oral sodium phosphate (P = 0.01). Intraluminal fluid was noted in 9 patients (90%) in the first group after a mean of 53 +/- 60 min, and in 17 patients (77%) in the second group after a mean of 158 +/- 71 min (P < 0.001). The proportion of non-ideal preparation was significantly higher in group 1 than in group 2, significant visualization disturbances being more prevalent in the first period.


CONCLUSIONS
Bowel preparation with sodium phosphate before capsule endoscopy offers better visualization than overnight fasting alone and induces fewer disturbances by intraluminal turbid fluid.
Niv
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Y
Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petach Tiqwa, Israel. nivyaron@013.net.il
Niv
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G
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005215:Fasting; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010710:Phosphates / Q000008:administration & dosage*; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D007507:Therapeutic Irrigation / Q000379:methods
D010710:Phosphates; C018279:sodium phosphate