Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study

Togashi, Kazutomo; Fujita, Toshio; Utano, Kenichi; Waga, Eriko; Katsuki, Shinichi; Isohata, Noriyuki; Endo, Shunsuke; Lefor, Alan Kawarai

doi:10.1055/s-0034-1393075

Cited by 30 publications

(42 citation statements)

References 12 publications

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“…Also, there were the patients who detected polyps on this testing. There is also are port of a way using Gastrografin [9], the castor-oil, the cost is low. Castor-oil regimens were also possible to reduce the water intake.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy in the Patients on Dialysis

Hotta¹

2017

OJMI

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Since Colon capsule endoscopy (CCE) was approved for reimbursement under the national health insurance system of Japan in January 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile intestine, impaired platelet function, or oral administration of nonsteroidal antiinflammatory drugs (NSAIDs) or anticoagulants. Increasing experience with CCE different bowel preparation regimens have been used with variable results. The patient on dialysis has moisture restrictions. We experienced the case of the half a dose of the previous protocol by a method using the castor oil. In this study, we evaluated the efficacy of bowel preparation with castor oil for improving the capsule excretion rate. In 23 of 24 (95.8%) patients capsule transit time and duration of capsule endoscopy were shortened. The results are presented and briefly discussed in this report.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy in the Patients on Dialysis

Hotta¹

2017

OJMI

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“…Ricinoleic acid causes catharsis by stimulating the small intestine. Although the use of Gastrografin [10] has been reported, we used castor oil because it is inexpensive and is covered by the national health insurance system of Japan. The capsule excretion rate was 53.3% in dialysis patients treated according to the original protocol of bowel preparation.…”

Section: Discussionmentioning

confidence: 99%

The Use of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy

Hotta¹

2016

OJMI

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Colon capsule endoscopy was approved for reimbursement under the national health insurance system of Japan in 2014. At our hospital, specialized mainly in renal, hepatic, and diabetic diseases, we have been performing colon capsule endoscopy since December 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile intestine, impaired platelet function, or oral administration of nonsteroidalanti inflammatory drugs (NSAIDs) or anticoagulants. For this reason, detailed examination by capsule endoscopy appears to be useful. However, the capsule excretion rate after recommended bowel preparation reportedly ranges from 70% to 90%, and administration of boosters is also necessary. For dialysis patients, liquid loading is a problem. In this study, we evaluated the efficacy of bowel preparation with castor oil for improving the capsule excretion rate. In all 20 patients (including four dialysis patients), both capsule transit time and duration of capsule endoscopy were shortened. The results are presented and briefly discussed in this report.

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“…Gastrographin (water-soluble iodinated radiopaque oral contrast medium) was first used as CCE regimen in the study by Spada comparing CCE versus CCT (21), because this contrast is generally used as part of the CT colonography regimen for "fecal tagging". In a Japanese study, gastrographin appears to be useful and safe as a booster (24). Prokinetics have failed to show any additional benefit (25).…”

Section: Recommendation Grade D) Cce Is a Feasible And Safe Tool Fmentioning

confidence: 96%

Is capsule colonoscopy the solution for incomplete conventional colonoscopy?

Mascarenhas¹

2017

Rev Esp Enferm Dig

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The era of colon capsule endoscopy (CCE) started in 2007 (1). Few years later second-generation CCE (CCE-2) (Medtronic, Minneapolis, USA) was launched, featuring an improved optical system allowing for nearly 360° coverage via two 172° angle cameras, and adaptive frame rate function (ranging from 4 to 35 images per second depending on capsule motion).At present the main clinical indications for CCE are: a) completion of incomplete colonoscopy; b) polyp detection; and c) investigation of inflammatory bowel disease (IBD).Colon capsule endoscopy (CCE-2) was shown to be a reliable tool for the detection of colonic lesions such as polyps and tumors. The ability of CCE to identify colonic polyps and colorectal cancer (CCR) has been the goal of several studies, which were recently subjected to a meta-analysis pooling data from 14 studies (2). The accuracy of first-generation CCE (CCE-1) was tested in 7 studies involving 1,128 patients. CCE-2 was studied in 1,292 patients included in another series of 7 studies. This analysis showed that, while the sensitivity values for polyp detection achieved by CCE-1 studies were relatively low (58% and 54% for ≥ 6 mm and ≥ 10 mm polyps, respectively), those reported in CCE-2 studies were more acceptable (i.e., sensitivity of 86% and 87% for ≥ 6 mm and ≥ 10 mm polyps, respectively; specificity of 88.1% and 95.3% for ≥ 6 mm and 10 mm polyps, respectively). In addition, CCE-2 identified all 11 invasive cancers that were detected by colonoscopy. The authors concluded that high specificity values for polyp detection seem to be achievable by CCE-2 with a 10 mm cutoff in a screening setting.Conventional colonoscopy is the gold-standard procedure for the screening of bowel cancer. While complete examination of the large bowel is essential to detect abnormalities, incomplete colonoscopies (ICs) do occur. Population-based studies have found that, in clinical practice, cecal intubation rates (CIR) are variable between centers within the range of 80-95% (3), far from the targets established by different national and international specialty associations (4,5).The consequences of incomplete colonoscopy may be unfortunate. The term "post-colonoscopy colo-rectal cancer" (PCCRC) has been coined for interval cancers in patients having undergone colonoscopy. PCCRCs may represent a missed cancer, a cancer arising in a missed or incompletely treated adenoma, or a cancer that started to develop after colonoscopy. Missed cancers may result from several factors, including poor bowel preparation or reduced withdrawal time, but most important is incomplete colonoscopy. Higher post-colonoscopy colorectal cancer (PCCRC) rates are found for endoscopists with a lower CIR (6), and in cases of incomplete colonoscopy (7), with PCCRCs being more frequent in the right side of the colon.These data make it clear that all patients with incomplete screening colonoscopy should be re-examined. Several alternatives may be used. Patients may undergo a successful repeat colonoscopy at a tertiary referral center with dedicate...

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Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study

Cited by 30 publications

References 12 publications

Usefulness of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy in the Patients on Dialysis

Usefulness of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy in the Patients on Dialysis

The Use of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy

Is capsule colonoscopy the solution for incomplete conventional colonoscopy?

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