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

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 2 l of a polyethylene glycol and simethicone solution 16 h 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 288 min 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 2 l of a polyethylene glycol and simethicone solution before VCE.