Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy

Background: Small-bowel contents can hamper the quality of video-capsule endoscopy (VCE). No standardized protocol has been proposed and overnight fasting remains the proposed preparation for VCE. Aims: The aim was to evaluate the effects of 2 regimens of bowel preparation on small intestine cleansing, diagnostic yield and capsule transit times. Methods: This is a prospective, randomized, blinded, and controlled study. Sixty patients referred for VCE were randomized into 2 groups. Group A ingested 2. l of a polyethylene glycol and simethicone solution 16. h before VCE. Group B were instructed to consume a fibre-free diet and allowed to consume clear liquids the day before VCE. The small-bowel cleansing was graded as " complete" if the entire wall was assessable, " incomplete" if more than 50% of the wall was visible, and " insufficient" if less than 50% of the wall was visible. Results: In group A, a " complete" , " incomplete" and " insufficient" small-bowel cleansing was achieved in 42%, 39% and 19% of cases respectively. In group B, a " complete" , " incomplete" and " insufficient" small-bowel cleansing was achieved in 43%, 33% and 24% of cases respectively. No significant differences were observed between the two groups, regarding small-bowel cleansing level (p=0.65). No differences were also observed in the diagnostic yield (48.2%, 13.8% and 38% vs 65.5%, 6.9% and 27.6% of positive, suspicious and no findings respectively, in groups A and B [p=0.39]) and small-bowel transit times (mean 288. min and 299. min in groups A and B respectively [p=0.70]). Conclusions: The results of the present study do not support the use of 2. l of a polyethylene glycol and simethicone solution before VCE. © 2009 Editrice Gastroenterologica Italiana S.r.l.