Small bowel cleansing for capsule endoscopy in paediatric patients: A prospective randomized single-blind study

Clinical Practice Guidelines for the Use of Video Capsule Endoscopy

“…147 Two RCTs published after the meta-analysis also reported improved visualization with the combination of PEG þ simethicone, but again no improvements in completion rates. 152,153 Two RCTs comparing low-and high-volume PEG cleansing strategies before CE found no significant differences in visualization, transit times, cleansing scores, or completion rates between the 2 regimens. 153,155 Two studies found that administration of low-dose PEG (500 mL), with or without metoclopramide, within 1-2 hours of swallowing the capsule also could improve image quality.…”

“…152,153 Two RCTs comparing low-and high-volume PEG cleansing strategies before CE found no significant differences in visualization, transit times, cleansing scores, or completion rates between the 2 regimens. 153,155 Two studies found that administration of low-dose PEG (500 mL), with or without metoclopramide, within 1-2 hours of swallowing the capsule also could improve image quality. 156,157 In a systematic review of studies in the setting of colonoscopy, bowel preparations generally were well tolerated and no clinically significant complications were reported.…”

“…Systematic reviews and RCTs have shown that adequate bowel preparation can improve the quality of visualization when used before CE. [147][148][149][150][151][152][153][154] A systematic review of 15 RCTs comparing bowel cleansing with no preparation other than a clear fluid diet, found that PEG (1, 2, or 4 L) before CE significantly increased the odds of adequate visualization (odds ratio, 3.13; 95% CI, 1.70-5.75; P ¼ .0002) and diagnostic yield (odds ratio, 1.68; 95% CI, 1.16-2.42; P ¼ .006). 147 Sodium phosphate improved the diagnostic yield (odds ratio, 1.77; 95% CI, 1.18-2.64; P ¼ .005), without affecting visualization quality.…”

Capsule endoscopy followed by single balloon enteroscopy in children with obscure gastrointestinal bleeding: A combined approach

“…At the same time, the success rate for enteroscopy procedures is significantly greater when performed at referral centres than in community practices, suggesting that the experience of the operator may play a primary role in achieving such a result [21,30,31]. Follow-up ranged from 10 to 42 months (median 19.5 months).…”

“…In preparation, a 25 ml/kg of polyethylene glycol-based solution plus simethicone was given in the afternoon on the day prior to the procedure (SelgEsse, Promefarm, Milan, Italy) [21]. Patients swallowed the capsule in the morning.…”