BACKGROUND AND OBJECTIVE: There is no consensus concerning small bowel preparation before capsule endoscopy (CE). This study evaluated the effects of 4 regimens on small bowel cleansing and diagnostic yield. METHODS: Patients were randomly divided into 4 groups. Group A consumed a clear liquid diet after lunch on the day before CE, followed by overnight fasting. Group B took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In group C, the same regimen was taken at 20:00 hours on the day before and at 05:00 hours on the day of CE. In group D, in addition to the group C regimen, 20 mL oral simethicone was taken 30 minutes before CE. RESULTS:Two hundred patients were prospectively enrolled, and 7 were excluded from the final analysis because of incomplete small bowel transit. No significant difference was noted among the 4 groups for small bowel transit time. Bowel preparation in group D was significantly better than for the other regimens for overall cleansing of the proximal small bowel, and showed improved overall cleansing of the distal small bowel when compared with 10-hours overnight fasting. Pathological lesions of the proximal and distal small bowel were, respectively, achieved in 82 and 74 patients, mostly distributed in group D. CONCLUSIONS: Small bowel preparation that involves split-dose oral mannitol plus single-dose simethicone for CE can improve mucosal visualization and subsequent diagnostic yield when compared with 10-hours overnight fasting.
RCT Entities:
BACKGROUND AND OBJECTIVE: There is no consensus concerning small bowel preparation before capsule endoscopy (CE). This study evaluated the effects of 4 regimens on small bowel cleansing and diagnostic yield. METHODS:Patients were randomly divided into 4 groups. Group A consumed a clear liquid diet after lunch on the day before CE, followed by overnight fasting. Group B took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In group C, the same regimen was taken at 20:00 hours on the day before and at 05:00 hours on the day of CE. In group D, in addition to the group C regimen, 20 mL oral simethicone was taken 30 minutes before CE. RESULTS: Two hundred patients were prospectively enrolled, and 7 were excluded from the final analysis because of incomplete small bowel transit. No significant difference was noted among the 4 groups for small bowel transit time. Bowel preparation in group D was significantly better than for the other regimens for overall cleansing of the proximal small bowel, and showed improved overall cleansing of the distal small bowel when compared with 10-hours overnight fasting. Pathological lesions of the proximal and distal small bowel were, respectively, achieved in 82 and 74 patients, mostly distributed in group D. CONCLUSIONS: Small bowel preparation that involves split-dose oral mannitol plus single-dose simethicone for CE can improve mucosal visualization and subsequent diagnostic yield when compared with 10-hours overnight fasting.
Authors: Cristiano Spada; Deirdre McNamara; Edward J Despott; Samuel Adler; Brooks D Cash; Ignacio Fernández-Urién; Hrvoje Ivekovic; Martin Keuchel; Mark McAlindon; Jean-Christophe Saurin; Simon Panter; Cristina Bellisario; Silvia Minozzi; Carlo Senore; Cathy Bennett; Michael Bretthauer; Mario Dinis-Ribeiro; Dirk Domagk; Cesare Hassan; Michal F Kaminski; Colin J Rees; Roland Valori; Raf Bisschops; Matthew D Rutter Journal: United European Gastroenterol J Date: 2019-05-15 Impact factor: 4.623
Authors: Salvatore Oliva; Stanley A Cohen; Giovanni Di Nardo; Gianfranco Gualdi; Salvatore Cucchiara; Emanuele Casciani Journal: World J Gastroenterol Date: 2014-11-28 Impact factor: 5.742
Authors: In Kyung Yoo; Yoon Tae Jeen; Seung Hun Kang; Jae Hyung Lee; Seung Han Kim; Jae Min Lee; Hyuk Soon Choi; Eun Sun Kim; Bora Keum; Hoon Jai Chun; Hong Sik Lee; Chang Duck Kim Journal: Medicine (Baltimore) Date: 2016-07 Impact factor: 1.889