title: Superiority of the Split-dose PEG Regimen for Small-Bowel Capsule Endoscopy: A Randomized Controlled Trial.
abstract: We aimed to evaluate the small-bowel cleansing quality, the diagnostic yield (DY), the transit time, and the patients' tolerability, by comparing the 2 different polyethylene glycol (PEG) administration schedules.
  
  
  
  The use of bowel purgatives before small-bowel capsule endoscopy (SBCE) is recommended by the ESGE guidelines. Whether this regimen can be further refined by changing the timing of administration is unknown.
  
  
  
  Fifty-seven patients were prospectively enrolled and randomized into 2 groups: group 1 (G1, n=29) received 2 L of PEG in the day before SBCE (time between PEG and SBCE=10 h); and group 2 (G2, n=28) received 1 L of PEG in the day before SBCE and 1 L of PEG in the morning before SBCE (time between PEG and SBCE=4 h). The primary outcome measure was small-bowel cleansing quality. Small-bowel cleansing quality was evaluated according to a previously validated grading scale.
  
  
  
  The entire and distal half small-bowel cleansing scores were significantly higher among G2 (median score: 8 vs. 10 points, P=0.012; median score: 6 vs. 8 points, P=0.05, respectively). The DY did not differ significantly between groups. There were no significant differences in transit times between the 2 PEG regimens. Both schedules were well tolerated, showing no differences regarding symptoms while ingesting the preparation or after SBCE ingestion.
  
  
  
  Split-dose PEG regimen for SBCE preparation improved the small-bowel cleanliness, did not interfere with transit times and was equally well tolerated by the patients. No differences were observed regarding DY. ClinicalTrial.gov registration: NCT02396017.
authors.affiliation: Gastroenterology Department, Egas Moniz Hospital, Western Lisbon Hospital Center, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Magalhães-Costa
authors.forename: Joana
authors.initials: J
authors.lastname: Carmo
authors.forename: Miguel
authors.initials: M
authors.lastname: Bispo
authors.forename: Sofia
authors.initials: S
authors.lastname: Santos
authors.forename: Cristina
authors.initials: C
authors.lastname: Chagas
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols