title: Randomized controlled trial of cholestyramine and hydrotalcite to eliminate bile for capsule endoscopy.
abstract: OBJECTIVE
  Bile is the main cause of poor bowel preparation for capsule endoscopy (CE). We aimed to determine whether cholestyramine and hydrotalcite can eliminate bile in the bowel.
  
  
  METHODS
  Patients undergoing CE were randomized into two groups. Group A patients (n = 75) received 250 mL 20% mannitol and 1 L 0.9% saline orally at 20:00 hours on the day before and at 05:00 hours on the day of CE and 20 mL simethicone 30 min before CE. Group B patients (n = 73) were treated identically, except for taking oral cholestyramine and hydrotalcite, starting 3 days before CE. Greenish luminal contents were assessed by four tissue color bar segments using Color Area Statistics software. Bowel cleanliness was evaluated by visualized area percentage assessment of cleansing (AAC) score.
  
  
  RESULTS
  Bowel cleanliness (82.7% [62/75] vs 46.6% [34/73]; χ2 = 14.596, P = 0.000). and detected greenish luminal contents (20.0% [15/75] vs 8.2% [6/73]; χ2 = 4.217, P = 0.040) were significantly greater in Group A than in Group B. Greenish luminal contents in the two groups differed significantly in the captured small-bowel (t = -13.74, P = 0.000) segments and proximal small-bowel (t = -0.7365, P = 0.000) segments, but not for the distal small-bowel (t = -0.552, P = 0.581) segments.
  
  
  CONCLUSIONS
  Cholestyramine and hydrotalcite were ineffective in eliminating bile and improving small-bowel preparation.
authors.forename: Chen
authors.initials: C
authors.lastname: Hong-Bin
authors.affiliation: Department of Gastroenterology, Sanming First Hospital Affiliated to Fujian Medical University, Sanming, China.
authors.forename: Huang
authors.initials: H
authors.lastname: Yue
authors.forename: Huang
authors.initials: H
authors.lastname: Chun
authors.forename: Xiao
authors.initials: X
authors.lastname: Shu-Ping
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yue
authors.forename: Li
authors.initials: L
authors.lastname: Xiao-Lin
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000536:Aluminum Hydroxide / Q000008:administration & dosage*; D000934:Antifoaming Agents / Q000008:administration & dosage; D001646:Bile / Q000187:drug effects*; D053704:Capsule Endoscopy / Q000379:methods*; D002792:Cholestyramine Resin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D008276:Magnesium Hydroxide / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000934:Antifoaming Agents; D002792:Cholestyramine Resin; C010467:hydrotalcite; D000536:Aluminum Hydroxide; D008276:Magnesium Hydroxide