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

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Procedures
• Gastrointestinal Diagnostics

Background:

• Capsule endoscopy is a valuable tool for visualizing the small bowel.
• No prior studies have established optimal bowel preparation protocols for pediatric capsule endoscopy.

Purpose of the Study:

• To compare the efficacy of five different bowel preparation regimens in children undergoing capsule endoscopy.
• To determine the optimal preparation for achieving adequate mucosal visualization and diagnostic yield.

Main Methods:

• A randomized controlled trial involving 198 pediatric patients.
• Evaluation of five bowel preparation groups: clear liquid diet, high-volume polyethylene glycol, low-volume polyethylene glycol, simethicone, and polyethylene glycol plus simethicone.
• Assessment of mucosal visibility surface as the primary outcome measure.

Main Results:

• The combination of polyethylene glycol (25 mL/kg) and simethicone (20 mL) yielded the highest mucosal visualization scores (20.9 ± 4.6).
• Significant differences in visualization scores were observed across the groups (P < 0.01).
• No significant differences in diagnostic yield or tolerability were noted between the regimens.

Conclusions:

• The combination of low-volume polyethylene glycol solution and simethicone is the recommended preparation for pediatric capsule endoscopy.
• This regimen provides superior mucosal visualization, enhancing the diagnostic potential of the procedure in children.