Is a 2-liter PEG preparation useful before capsule endoscopy?
OBJECTIVE
Small bowel contents can sometimes hamper the quality of capsule images. Our aim was to investigate the effect of PEG administered prior to capsule endoscopy (CE) upon quality of images, gastrointestinal transit time, and detection rate of small bowel bleeding lesions in patients with obscure gastrointestinal bleeding.


METHODS
Forty-two consecutive patients were included. CE was performed following a 12-hour fasting period. The 16 first patients (Group A) received no preparation and the following 27 patients (Group B) received 2 L of PEG the night before. The quality of images was assessed at both in duodenojejunum and ileum level, using a scale including the presence of air bubbles, biliary secretion, and residue (1-4).


RESULTS
Quality of images were not different in Group A compared with Group B in the duodenojejunum and in the ileum. Gastric transit time tended to be shorter in Group A compared with Group B (25.5 vs. 45.7 minutes) (P = 0.15), whereas small bowel transit was not different between both groups (271 vs. 288 minutes). Total small bowel CE examination was complete in Group A and in 24 of 26 in Group B (not significant). Potential bleeding lesions were seen in 8 patients in Group A and 12 in Group B (not significant).


CONCLUSIONS
Our retrospective study suggests that 2 L PEG preparation seems able to improve neither the quality of CE images nor its diagnostic performance. Moreover, in our study, PEG tended to increase gastric emptying time and may constitute a limitation for small bowel complete examination.
Ben-Soussan
Emmanuel
E
Rouen University Hospital Ch. Nicolle, Rouen, France. emmanuel.ben-soussan@chu-rouen.fr
Savoye
Guillaume
G
Antonietti
Michel
M
Ramirez
Simon
S
Ducrotté
Philippe
P
Lerebours
Eric
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004333:Drug Administration Routes; D016099:Endoscopy, Gastrointestinal / Q000379:methods* / Q000592:standards; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011300:Preoperative Care / Q000379:methods*; D013501:Surface-Active Agents / Q000008:administration & dosage
D013501:Surface-Active Agents; D011092:Polyethylene Glycols