Bowel Preparation for Capsule Endoscopy: A Prospective Randomized Multicenter Study
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Background/Aims: The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations. Methods: A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure. Results: Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups. Conclusions: Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.
Abstract
Background/Aims: The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations. Methods: A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure. Results: Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups. Conclusions: Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.
참고문헌 (16)
- Costamagna G, "A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease", Gastroenterology, 123, pp.999~1005 (2002)
- Lewis B, "Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study", Gastrointest Endosc, 56, pp.349~353 (2002)
- Mylonaki M, "Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding", Gut, 52, pp.1122~1126 (2003)
- 천재희, "Recent Advances of Endoscopy in Inflammatory Bowel Diseases", Gut and Liver, 1(2), pp.118~125 (2007), 거트앤리버 발행위원회
- Albert J, "Simethicone for small bowel preparation for capsule endoscopy: a systematic, single-blinded, controlled study", Gastrointest Endosc, 59, pp.487~491 (2004)
- Viazis N, "Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study", Gastrointest Endosc, 60, pp.534~538 (2004)
- van Tuyl SA, "Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study", Endoscopy, 39, pp.1037~1040 (2007)
- Dai N, "Improved capsule endoscopy after bowel preparation", Gastrointest Endosc, 61, pp.28~31 (2005)
- Niv Y, "Capsule endoscopy: role of bowel preparation in successful visualization", Scand J Gastroenterol, 39, pp.1005~1009 (2004)
- Wei W, "Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging", Am J Gastroenterol, 103, pp.77~82 (2008)
- Fireman Z, "Capsule endoscopy: improving the transit time and the image view", World J Gastroenterol, 11, pp.5863~5866 (2005)
- Ben-Soussan E, "Is a 2-liter PEG preparation useful before capsule endoscopy?", J Clin Gastroenterol, 39, pp.381~384 (2005)
- Kastenberg D, "Efficacy and safety of sodium phosphate tablets compared with PEG solution in colon cleansing: two identically designed, randomized, controlled, parallel group, multicenter phaseIII trials", Gastrointest Endosc, 54, pp.705~713 (2001)
- Aronchick CA, "A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda", Gastrointest Endosc, 52, pp.346~352 (2000)
- Pennazio M, "Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases", Gastroenterology, 126, pp.643~653 (2004)
- Fireman Z, "Effect of oral purgatives on gastric and small bowel transit time in capsule endoscopy", Isr Med Assoc J, 6, pp.521~523 (2004)