Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy

Dig Liver Dis. 2010 May;42(5):365-70. doi: 10.1016/j.dld.2009.07.017. Epub 2009 Sep 6.

Abstract

Background: Small-bowel contents can hamper the quality of video-capsule endoscopy (VCE). No standardized protocol has been proposed and overnight fasting remains the proposed preparation for VCE.

Aims: The aim was to evaluate the effects of 2 regimens of bowel preparation on small intestine cleansing, diagnostic yield and capsule transit times.

Methods: This is a prospective, randomized, blinded, and controlled study. Sixty patients referred for VCE were randomized into 2 groups. Group A ingested 2l of a polyethylene glycol and simethicone solution 16h before VCE. Group B were instructed to consume a fibre-free diet and allowed to consume clear liquids the day before VCE. The small-bowel cleansing was graded as "complete" if the entire wall was assessable, "incomplete" if more than 50% of the wall was visible, and "insufficient" if less than 50% of the wall was visible.

Results: In group A, a "complete", "incomplete" and "insufficient" small-bowel cleansing was achieved in 42%, 39% and 19% of cases respectively. In group B, a "complete", "incomplete" and "insufficient" small-bowel cleansing was achieved in 43%, 33% and 24% of cases respectively. No significant differences were observed between the two groups, regarding small-bowel cleansing level (p=0.65). No differences were also observed in the diagnostic yield (48.2%, 13.8% and 38% vs 65.5%, 6.9% and 27.6% of positive, suspicious and no findings respectively, in groups A and B [p=0.39]) and small-bowel transit times (mean 288min and 299 min in groups A and B respectively [p=0.70]).

Conclusions: The results of the present study do not support the use of 2l of a polyethylene glycol and simethicone solution before VCE.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Capsule Endoscopy*
  • Cathartics / administration & dosage*
  • Double-Blind Method
  • Exophthalmos
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage*
  • Prospective Studies
  • Simethicone / administration & dosage*
  • Young Adult

Substances

  • Cathartics
  • Polyethylene Glycols
  • Simethicone