title: Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study.
abstract: OBJECTIVE
  To obtain an adequate view of the whole small intestine during capsule endoscopy (CE) a clear liquid diet and overnight fasting is recommended. However, intestinal content can hamper vision in spite of these measures. Our aim was to evaluate tolerance and degree of intestinal cleanliness during CE following three types of bowel preparation.
  
  
  METHODS
  This was a prospective, multicenter, randomized, controlled study. Two-hundred ninety-one patients underwent one of the following preparations: 4 L of clear liquids (CL) (group A; 92 patients); 90 mL of aqueous sodium phosphate (group B; 89 patients); or 4 L of a polyethylene glycol electrolyte solution (group C; 92 patients). The degree of cleanliness of the small bowel was classified by blinded examiners according to four categories (excellent, good, fair or poor). The degree of patient satisfaction, gastric and small bowel transit times, and diagnostic yield were measured.
  
  
  RESULTS
  The degree of cleanliness did not differ significantly between the groups (P = 0.496). Interobserver concordance was fair (k = 0.38). No significant differences were detected between the diagnostic yields of the CE (P = 0.601). Gastric transit time was 35.7 ± 3.7 min (group A), 46.1 ± 8.6 min (group B) and 34.6 ± 5.0 min (group C) (P = 0.417). Small-intestinal transit time was 276.9 ± 10.7 min (group A), 249.7 ± 13.1 min (group B) and 245.6 ± 11.6 min (group C) (P = 0.120). CL was the best tolerated preparation. Compliance with the bowel preparation regimen was lowest in group C (P = 0.008).
  
  
  CONCLUSIONS
  A clear liquid diet and overnight fasting is sufficient to achieve an adequate level of cleanliness and is better tolerated by patients than other forms of preparation.
authors.affiliation: Gastroenterology Unit, La Fe University and Polytechnic Hospital, Valencia, Spain. pons_vicbel@gva.es
authors.forename: Vicente
authors.initials: V
authors.lastname: Pons Beltrán
authors.forename: Begoña
authors.initials: B
authors.lastname: González Suárez
authors.forename: Cecilia
authors.initials: C
authors.lastname: González Asanza
authors.forename: Enrique
authors.initials: E
authors.lastname: Pérez-Cuadrado
authors.forename: Servando
authors.initials: S
authors.lastname: Fernández Diez
authors.forename: Iñaqui
authors.initials: I
authors.lastname: Fernández-Urién
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mata Bilbao
authors.forename: Jorge Carlos
authors.initials: JC
authors.lastname: Espinós Pérez
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Pérez Grueso
authors.forename: Lidia
authors.initials: L
authors.lastname: Argüello Viudez
authors.forename: Julio
authors.initials: J
authors.lastname: Valle Muñoz
authors.forename: Fernando
authors.initials: F
authors.lastname: Carballo Alvarez
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Navas
authors.forename: Jose
authors.initials: J
authors.lastname: Llach Vila
authors.forename: Juan Andrés
authors.initials: JA
authors.lastname: Ramírez Armengol
authors.forename: Joaquin
authors.initials: J
authors.lastname: Balanzó Tintoré
authors.forename: Teresa
authors.initials: T
authors.lastname: Sala Felis
authors.forename: Pedro
authors.initials: P
authors.lastname: Menchen Fernández-Pacheco
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods*; D002400:Cathartics / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D005215:Fasting; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010710:Phosphates / Q000494:pharmacology; D011092:Polyethylene Glycols / Q000494:pharmacology; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002400:Cathartics; D004573:Electrolytes; D010710:Phosphates; D011092:Polyethylene Glycols; C018279:sodium phosphate