Comparison of two schemes of small bowel preparation for capsule endoscopy with polyethylene glycol: a prospective, randomized single-blind study

Abstract

Small bowel preparation for capsule endoscopy remains controversial. This study was conducted to compare the efficacy of 2 and 4 l of polyethylene glycol. One hundred and one patients (group A) received 2 l and 100 (group B) received 4 l in a prospective, randomized single-blind trial. To objectively evaluate enteric preparation, a cleansing coefficient was calculated for each patient. The two groups were found comparable regarding age, sex, body mass index, and reason for referral. In 82 patients of group A and in 76 of group B, examination of small bowel was completed (P =0.40). Gastric emptying time and small bowel transit time were found comparable in both groups. Cleansing coefficients, for small bowel as a whole or for proximal or distal separately, were similar among the two groups. However, the cleansing coefficient of the proximal bowel was significantly higher than that of the distal, independently of preparation (group A: P < 0.001, group B: P< 0.001). Small bowel preparation was related only with the age of the patients and gastric emptying time; the younger the patient or the shorter the gastric emptying time, the higher the cleansing coefficient. Pathological findings were found in 43 (42.6%) patients of group A and in 37 (37.0%) patients of group B (P =0.42). A final positive diagnosis was established in 33 (32.7%) patients of group A and in 29 (29.0%) of group B (P = 0.57). The two schemes were equal regarding enteric cleansing and completion of the procedure. Therefore, 2 l seems to be an adequate preparation for capsule endoscopy.