title: Modified bowel preparation regimen for use in second-generation colon capsule endoscopy in patients with ulcerative colitis.
abstract: OBJECTIVE
  We have reported that second-generation colon capsule endoscopy (CCE-2) might be feasible for assessing the severity of mucosal inflammation in ulcerative colitis (UC). However, because of the low rate (69%) of complete evaluation of the colon and owing to inadequate cleansing. We believe that the method of bowel preparation could be improved by reducing volume. In the present study, we attempted to improve the colon-cleansing regimen in order to optimize the usefulness of CCE-2 in the management of UC patients.
  
  
  METHODS
  Twenty patients with histologically confirmed UC were enrolled. Patients took a maximum 2.2 L lavage solution (polyethylene glycol solution and magnesium citrate) in two or three divided doses. To assess the effectiveness of the modified bowel preparation regimen, we evaluated the rate of total colonobservation, the effectiveness of bowel cleansing, andinterobserver agreement in assessing UC disease activity. We used a four-point grading scale (poor, fair, good, and excellent) for evaluating the quality of bowel cleansing. Matts' endoscopic score was used to evaluate disease activity.
  
  
  RESULTS
  The rate of total colon observation was 85%, and 15 patients (75%) excreted the CCE-2 within 8 h. The proportion of excellent plus good cleansing was approximately 60%. There was a substantial interobserver agreement (κ = 0.777) in assessment of overall cleansing, which was still substantial at the fair cleansing level (κ = 0.700).
  
  
  CONCLUSIONS
  Using CCE-2, the modified bowel preparation regimen, with reduced volume has the potential to succeed in the evaluation of mucosal severity in UC.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Usui
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosoe
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Taku
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakano
authors.forename: Makoto
authors.initials: M
authors.lastname: Naganuma
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kimura
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yoneno
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Hisamatsu
authors.forename: Nagamu
authors.initials: N
authors.lastname: Inoue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Serizawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogata
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D002400:Cathartics / Q000008:administration & dosage*; D003093:Colitis, Ulcerative / Q000175:diagnosis*; D004733:Enema / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols
keywords: bowel preparation; colon capsule endoscopy; magnesium citrate; polyethylene glycol; ulcerative colitis