Bowel preparation for capsule endoscopy: a prospective randomized multicenter study.
OBJECTIVE
The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations.


METHODS
A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure.


RESULTS
Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups.


CONCLUSIONS
Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.
Wi
Jun-Hwan
JH
Institute for Digestive Research, Digestive Disease Center, Soon Chun Hyang University Hospital, Seoul, Korea.
Moon
Jeong-Seop
JS
Choi
Myung-Gyu
MG
Kim
Jin Oh
JO
Do
Jae Hyuk
JH
Ryu
Ji-Kon
JK
Shim
Ki-Nam
KN
Lee
Kwang Jae
KJ
Jang
Byung Ik
BI
Chun
Hoon Jai
HJ