Effect of erythromycin on image quality and transit time of capsule endoscopy: a two-center study.
OBJECTIVE
To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy (CE) in evaluating small bowel (SB) pathology.


METHODS
We conducted a retrospective, blinded (to the type of preparation) review of 100 CE studies, 50 with no preparation with prokinetics from one medical center (Group A) and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE (Group B). Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine.


RESULTS
The erythromycin group had a slightly shorter gastric transit time (21 min vs 28 min, with no statistical significance). SB transit time was similar for both groups (all P > 0.05). Total transit time was almost identical in both groups. The rate of incomplete examination was 16% for Group A and 10% for Group B (P = 0.37). Bile and cleanliness scores in different parts of the intestine were similar for the two groups (P > 0.05).


CONCLUSIONS
Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time. It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate. Erythromycin does not adversely affect image quality. We consider the routine use of oral erythromycin preparation as being unjustified, although it might be considered in patients with known prolonged gastric emptying time.
Niv
Eva
E
Department of Gastroenterology, Hillel Yaffe Medical Center, PO Box 169, Hadera 38100, Israel. niv_em@netvision.net.il
Bonger
Ido
I
Barkay
Olga
O
Halpern
Zamir
Z
Mahajna
Elisabeth
E
Depsames
Roman
R
Kopelman
Yael
Y
Fireman
Zvi
Z
D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D003424:Crohn Disease / Q000473:pathology / Q000503:physiopathology; D004917:Erythromycin / Q000494:pharmacology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000503:physiopathology; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D004917:Erythromycin