Comparing 1-L and 2-L Polyethylene Glycol with Ascorbic Acid for Small Bowel Capsule Endoscopy: A Randomized...

Area of Science:

• Gastroenterology
• Endoscopy
• Diagnostic Imaging

Background:

• Small bowel capsule endoscopy (SBCE) is standard for diagnosing small bowel lesions.
• Optimal visualization requires effective bowel preparation, but large volumes are poorly tolerated.
• This study compares reduced-volume (1-L) versus standard-volume (2-L) PEG with AA bowel preparation.

Purpose of the Study:

• To compare the efficacy and safety of 1-L PEG with AA versus 2-L PEG with AA for SBCE.
• To determine if a lower volume preparation is non-inferior for achieving adequate small bowel visibility.
• To assess diagnostic yield and patient tolerability.

Main Methods:

• Prospective, multicenter, non-inferiority study.
• 140 patients randomized to receive either 1-L or 2-L PEG with AA for SBCE.
• Primary outcome: adequate small bowel visibility quality (SBVQ); secondary outcomes: diagnostic yield, cecal intubation rate, adverse events.

Main Results:

• No significant difference in adequate SBVQ between 1-L and 2-L groups (94.0% vs 94.3%).
• Diagnostic yield (49.3% vs 48.6%) and cecal complete rates (88.1% vs 92.9%) were similar.
• Adverse event rates were comparable (12.9% vs 11.9%).

Conclusions:

• 1-L PEG with AA is non-inferior to 2-L PEG with AA for SBCE preparation.
• The 1-L regimen is a safe and effective alternative, improving patient tolerability.
• 1-L PEG with AA can be recommended as a standard bowel preparation method for SBCE.