Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled...

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopy

Background:

• Capsule endoscopy (CE) requires adequate small intestine visualization.
• Intestinal content can compromise CE imaging despite standard fasting and clear liquid diets.
• Effective bowel preparation is crucial for diagnostic accuracy in CE.

Purpose of the Study:

• To evaluate patient tolerance and small bowel cleanliness using three different bowel preparation regimens for capsule endoscopy.
• To compare the efficacy of clear liquids, sodium phosphate, and polyethylene glycol solutions in preparing the small bowel for CE.

Main Methods:

• A prospective, multicenter, randomized, controlled study involving 291 patients.
• Patients were randomized into three groups receiving: 4L clear liquids (CL), 90mL aqueous sodium phosphate, or 4L polyethylene glycol solution.
• Blinded examiners assessed small bowel cleanliness, and patient satisfaction, transit times, and diagnostic yield were measured.

Main Results:

• No significant differences in small bowel cleanliness or diagnostic yield were found between the three preparation groups.
• Clear liquid diet (CL) was the best-tolerated preparation.
• Patient compliance was lowest with the polyethylene glycol solution.

Conclusions:

• A clear liquid diet and overnight fasting provide sufficient small bowel cleanliness for capsule endoscopy.
• This regimen is better tolerated and ensures adequate visualization compared to other tested preparations.
• Standard clear liquid diet and fasting remain a viable and patient-friendly option for CE bowel preparation.