Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy.
BACKGROUND
Small-bowel contents can hamper the quality of video-capsule endoscopy (VCE). No standardized protocol has been proposed and overnight fasting remains the proposed preparation for VCE.


OBJECTIVE
The aim was to evaluate the effects of 2 regimens of bowel preparation on small intestine cleansing, diagnostic yield and capsule transit times.


METHODS
This is a prospective, randomized, blinded, and controlled study. Sixty patients referred for VCE were randomized into 2 groups. Group A ingested 2l of a polyethylene glycol and simethicone solution 16h before VCE. Group B were instructed to consume a fibre-free diet and allowed to consume clear liquids the day before VCE. The small-bowel cleansing was graded as "complete" if the entire wall was assessable, "incomplete" if more than 50% of the wall was visible, and "insufficient" if less than 50% of the wall was visible.


RESULTS
In group A, a "complete", "incomplete" and "insufficient" small-bowel cleansing was achieved in 42%, 39% and 19% of cases respectively. In group B, a "complete", "incomplete" and "insufficient" small-bowel cleansing was achieved in 43%, 33% and 24% of cases respectively. No significant differences were observed between the two groups, regarding small-bowel cleansing level (p=0.65). No differences were also observed in the diagnostic yield (48.2%, 13.8% and 38% vs 65.5%, 6.9% and 27.6% of positive, suspicious and no findings respectively, in groups A and B [p=0.39]) and small-bowel transit times (mean 288min and 299 min in groups A and B respectively [p=0.70]).


CONCLUSIONS
The results of the present study do not support the use of 2l of a polyethylene glycol and simethicone solution before VCE.
Spada
Cristiano
C
Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli, Largo A. Gemelli, 8, 00168 - Rome, Italy.
Riccioni
Maria E
ME
Familiari
Pietro
P
Spera
Gianluca
G
Pirozzi
Giuseppe A
GA
Marchese
Michele
M
Bizzotto
Alessandra
A
Ingrosso
Marcello
M
Costamagna
Guido
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D002400:Cathartics / Q000008:administration & dosage*; D004311:Double-Blind Method; D005094:Exophthalmos; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012841:Simethicone / Q000008:administration & dosage*; D055815:Young Adult
D002400:Cathartics; D011092:Polyethylene Glycols; D012841:Simethicone