Ensure preparation and capsule endoscopy: a two-center prospective study.

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopy

Background:

• Achieving optimal small bowel (SB) cleanliness for capsule endoscopy (CE) remains a challenge.
• Standard preparation protocols often have limitations in efficacy and patient tolerance.
• Liquid, fiber-free formulas are being explored as potentially superior alternatives.

Purpose of the Study:

• To compare the efficacy of Ensure, polyethylene glycol (PEG), and standard preparations for SB cleanliness and CE image quality.
• To evaluate patient tolerance and side effects associated with different CE preparation methods.

Main Methods:

• A prospective, two-center study involving 198 patients undergoing CE.
• Four preparation groups were compared: standard diet, light diet without fruits/vegetables, PEG preparation, and Ensure formula.
• SB cleanliness and duodenal bile presence were assessed by a blinded gastroenterologist using a four-point scale.

Main Results:

• Ensure preparation showed a trend towards improved SB cleanliness compared to a standard diet (P=0.06).
• Both PEG and Ensure preparations demonstrated better middle SB cleanliness than the standard diet (P=0.057-0.07).
• Ensure significantly reduced duodenal bile compared to PEG (P=0.053) and had notably fewer side effects (1 patient) than PEG (50 patients).

Conclusions:

• Ensure, a liquid, fiber-free formula, presents advantages over standard and PEG preparations for CE.
• Ensure offers comparable or improved SB cleanliness with significantly fewer adverse effects than PEG.
• This suggests Ensure may be a more suitable and tolerable option for CE preparation.