title: Optimal approach for small bowel capsule endoscopy using polyethylene glycol and metoclopramide with the assistance of a real-time viewer.
abstract: OBJECTIVE
  Capsule endoscopy is limited by the poor image quality of the distal bowel and incomplete small bowel transit. The aim of this study was to establish an optimal medication protocol for capsule endoscopy performed using a real-time viewer.
  
  
  METHODS
  A total of 80 patients were prospectively recruited. The patients were randomized into two groups: the 'conventional group' (without any preparation) and the 'real-time group' (in which a real-time viewer was attached). At 60 min after swallowing the capsule, if the capsule had reached the small bowel, 500 ml of polyethylene glycol was administered; if the capsule was still located in the stomach, 10 mg of metoclopramide was given intramuscularly, followed by 500 ml of polyethylene glycol solution.
  
  
  RESULTS
  The completion rate was significantly higher in the real-time group as compared with that in the conventional group (72.5 vs. 90.0%). Our protocol yielded a significantly improved image quality of the distal small bowel [image quality score = 1.6 vs. 3.0 (max 4.0)]. The detection rate of lesions in the distal small bowel was higher in the real-time group than in the conventional group.
  
  
  CONCLUSIONS
  The present study clearly showed that our protocol yielded an improved completion rate and also improved image quality.
authors.affiliation: Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosono
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Eiji
authors.initials: E
authors.lastname: Sakai
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sekino
authors.forename: Takashi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Seitaro
authors.initials: S
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Koide
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Chikako
authors.initials: C
authors.lastname: Tokoro
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005746:Gastric Emptying; D005772:Gastrointestinal Transit; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods*; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D008297:Male; D008787:Metoclopramide; D008875:Middle Aged; D011092:Polyethylene Glycols; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D011092:Polyethylene Glycols; D008787:Metoclopramide