Effect of Bowel Preparation with Polyethylene Glycol on Quality of Capsule Endoscopy

Park, Sung Chul; Keum, Bora; Seo, Yeon Seok; Kim, Yong Sik; Jeen, Yoon Tae; Chun, Hoon Jai; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

doi:10.1007/s10620-010-1500-2

Cited by 57 publications

(59 citation statements)

References 20 publications

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“…Various purgative and pro-kinetic bowel preparations have been studied to establish the ideal small bowel preparation method to maximize the diagnostic yield of VCE. Several early studies have supported the use of a purgative bowel cleanse prior to VCE [9,10,20,21]. On the contrary, a growing body of evidence suggests that a clear liquids bowel regimen prior to VCE produces equivalent image quality results and is better tolerated by patients.…”

Section: Discussionmentioning

confidence: 99%

Clear Liquids versus Polyethylene Glycol Preparation for Video Capsule Endoscopy of the Small Bowel: A Randomized Controlled Trial

2018

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Background: An effective bowel cleanse can improve the imaging quality of video capsule endoscopy (VCE). We aimed to further investigate the optimal small bowel cleanse method by comparing the efficacy of 4 L of clear liquids, 2 L of polyethylene glycol (PEG), and 4 L of PEG on the image quality of VCE. Methods: A randomized controlled, non-inferiority trial was performed comparing 4 L of clear liquids (Group A), 2 L of PEG (Group B), and 4 L of PEG (Group C). The primary endpoint was image quality between the groups. The secondary endpoints included patient tolerability and side effects. Results: Eighty-one patients were analyzed in group A, 84 patients were analyzed in group B, and 80 patients were analyzed in group C. Image quality scores revealed 4 L of clear liquids to be non-inferior to 2 L of PEG, and 2 L of PEG to be non-inferior to 4 L of PEG (p < 0.0167). Group A had a lower difficulty of completion rate than Group B and Group C and a lower rate of side effects when compared to Group C (p < 0.0167). Conclusion: Four liters of clear liquids should be considered a routine method for small bowel preparation prior to VCE.

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Section: Discussionmentioning

confidence: 99%

Clear Liquids versus Polyethylene Glycol Preparation for Video Capsule Endoscopy of the Small Bowel: A Randomized Controlled Trial

2018

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“…PEG solutions are non-absorbable and osmotically active and have been widely used in capsule endoscopy based on its ability to move through the bowel and potentially distend the lumen, wash out debris and bile, and possibly enhance small bowel transit time. The optimal dose of PEG that needs to be administered before SBCE is not entirely clear but 2 L appears to be sufficient [21][22][23] . A recent study concluded that the ingestion of a small amount of PEG after the swallowing of an endoscopy capsule significantly improved CE image quality, but did not enhance the completion rate to the cecum [24] .…”

Section: C B Amentioning

confidence: 99%

Oral purgative and simethicone before small bowel capsule endoscopy

Rosa¹,

Barbosa²,

Magalhães³

et al. 2013

WJGE

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AIM:To evaluate small bowel cleansing quality, diagnostic yield and transit time, comparing three cleansing protocols prior to capsule endoscopy. METHODS:Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols: patients in Group A underwent a 24 h liquid diet and overnight fasting; patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol (PEG) the evening before the procedure; patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion. Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor, fair, good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization. When there was no agreement between the two endoscopists, the images were reviewed and discussed until a consensus was reached. The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition. The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images. Positive endoscopic findings, gastric emptying time (GET) and small bowel transit time (SBTT) were recorded for each examination. RESULTS:There was a trend favoring Group B in achieving an acceptable (including fair, good or excellent) level of cleansing (Group A: 65%; Group B: 83.3%; Group C: 68.4%) [P = not significant (NS)] and favoring Group C in attaining an excellent level of cleansing (Group A: 10%; Group B: 16.7%; Group C: 21.1%) (P = NS). The number of patients with an adequate cleansing of the small bowel, corresponding to an excellent or good classification, was 5 (25%) in Group A, 5 (27.8%) in Group B and 4 (21.1%) in Group C (P = 0.892). Conversely, 7 patients (35%) in Group A, 3 patients (16.7%) in Group B and 6 patients (31.6%) in Group C were considered to have poor small bowel cleansing (P = 0.417), with significant fluid or debris such that the examination was unreliable. The proportion of patients with a significant amount of bubbles was 50% in Group A, 27.8% in Group B and 15.8% in Group C (P = 0.065). This was significantly lower in Group C when compared to Group A (P = 0.026). The mean GET was 27.8 min for Group A, 27.2 min for Group B and 40.7 min for Group C (P = 0.381). The mean SBTT was 256.4 min for Group A, 256.1 min for Group B and 258.1 min for Group C (P = 0.998). Regarding to the rate of complete examinations, the capsule reached the cecum in 20 patients (100%) in Group A, 16 patients (88.9%) in Group B and 17 patients (89.5%) in Group C (P = 0.312). A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A (12 patients), 44.4% in Group B (8 patients) and 57.8% in Group C (11 patients) (P = 0.587). BRIEF ARTICLE

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“…The amount of polyethylene glycol to be used has also been studied. Two liters of PEG has been found to be superior to none at all, but four liters of PEG has not been found to be of any further benefit [11,12].…”

Section: Preparation and Administrationmentioning

confidence: 93%

“…Results have been mixed. Purgatives appear to be of likely benefit [10][11][12]. Simethicone has been found to decrease intraluminal air bubbles and improve mucosal visibility, [79,80] but has also been shown to be inferior to magnesium citrate in grading of mucosal visibility [81].…”

Section: Poor Visualizationmentioning

confidence: 99%

Video Capsule Endoscopy: The Past, Present, and Future

Whitmer¹

2013

J Gastrointest Dig Syst

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Effect of Bowel Preparation with Polyethylene Glycol on Quality of Capsule Endoscopy

Abstract: Bowel preparation with PEG resulted in better image quality than fasting alone. No significant difference was observed between 2 and 4 l. PEG 2 l rather than 4 l may be a useful method of preparation for CE.

Cited by 57 publications

References 20 publications

Clear Liquids versus Polyethylene Glycol Preparation for Video Capsule Endoscopy of the Small Bowel: A Randomized Controlled Trial

Clear Liquids versus Polyethylene Glycol Preparation for Video Capsule Endoscopy of the Small Bowel: A Randomized Controlled Trial

Oral purgative and simethicone before small bowel capsule endoscopy

Video Capsule Endoscopy: The Past, Present, and Future

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