Improved capsule endoscopy after bowel preparation.
BACKGROUND
The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small-bowel wall and complete passage through the small bowel. This study examined the effect of bowel preparation on the volume of intestinal content and on small-bowel transit.


METHODS
Sixty-one consecutive patients (34 men, 27 women; mean age 56 years, range 17-88 years) were enrolled in the study. Although not randomized, 33 patients received a bowel preparation, and 28 had no preparation. Gastric emptying, small-bowel transit time, overall preparation assessment, and bowel-wall visualization were evaluated by 3 investigators who were unaware of whether the patient had undergone bowel preparation.


RESULTS
Small-bowel transit time was significantly shorter in patients with bowel preparation (median 213 minutes: 95% CI[190, 267]) than in those without preparation (median 253 minutes: 95% CI[228, 307]) (p <0.01). The capsule reached the cecum in 97% of patients in the bowel-preparation group, compared with 76% in the nonpreparation group (p=0.02). Bowel preparation improved the quality of visualization significantly; this effect was more pronounced in the distal small bowel.


CONCLUSIONS
This study demonstrated that bowel preparation accelerates small-bowel capsule transit and leads to a higher rate of complete capsule endoscopy. Visualization of the small bowel was improved by bowel preparation. Bowel preparation before capsule endoscopy is recommended.
Dai
Ning
N
Division of Gastroenterology, Sir Run Run Shaw Hospital, Clinical Research Institute, Zhejiang University, China.
Gubler
Christoph
C
Hengstler
Peter
P
Meyenberger
Christa
C
Bauerfeind
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D007421:Intestine, Small / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011300:Preoperative Care; D016037:Single-Blind Method; D013501:Surface-Active Agents / Q000008:administration & dosage*
D013501:Surface-Active Agents; D011092:Polyethylene Glycols