title: Small bowel cleansing for capsule endoscopy in paediatric patients: a prospective randomized single-blind study.
abstract: BACKGROUND
  Small bowel cleansing by capsule endoscopy has never been addressed in children.
  
  
  METHODS
  Randomized controlled trial to evaluate the effect of five bowel preparation regimens on the mucosal visibility surface (as percentage of visualized surface area). Group A: a clear liquid diet for 12 h on the day before; Group B: high volume polyethylene glycol (50 mL/kg, up to 2Lt/die); Group C: low volume polyethylene glycol (25 mL/kg up to 1Lt/die); Group D: 20 mL (376 mg) of oral simethicone; Group E: 25 mL/kg (up to 1Lt/die) of polyethylene glycol solution plus 20 mL (376 mg) of oral simethicone.
  
  
  RESULTS
  Overall, 198 patients (53% male, median age 13 years) were enrolled. Preparation regimen visualization scores were 14.1 ± 4.2, 18.9 ± 5.1, 17.8 ± 5.5, 14.9 ± 4.8 and 20.9 ± 4.6 in groups A, B, C, D and E, respectively (P < 0.01). Positive findings were found in 172 cases (87%), but no significant differences were observed in the diagnostic yield and tolerability. Interobserver agreement, k = 0.89 (95% CI 0.83 ± 0.71).
  
  
  CONCLUSIONS
  This is the first report in children that supports the use of 25 mL/kg (up to 1Lt/die) of polyethylene glycol solution plus 20 mL (376 mg) of oral simethicone as the preparation of choice for capsule endoscopy.
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Oliva
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spada
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ferrari
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy.
authors.forename: Fortunata
authors.initials: F
authors.lastname: Civitelli
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pagliaro
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy. Electronic address: giovanni.dinardo@uniroma1.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Nardo
mesh_terms: D000293:Adolescent; D000934:Antifoaming Agents / Q000627:therapeutic use*; D053704:Capsule Endoscopy / Q000379:methods*; D002400:Cathartics / Q000627:therapeutic use*; D002648:Child; D005215:Fasting; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D007421:Intestine, Small; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012841:Simethicone / Q000627:therapeutic use*; D016037:Single-Blind Method
chemical_list: D000934:Antifoaming Agents; D002400:Cathartics; D011092:Polyethylene Glycols; D012841:Simethicone
keywords: Bowel preparation; Capsule endoscopy; Crohn's disease; Paediatric endoscopy; Small bowel