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

Background: Small bowel cleansing by capsule endoscopy has never been addressed in children. Methods: Randomized controlled trial to evaluate the effect of five bowel preparation regimens on the mucosal visibility surface (as percentage of visualized surface area). Group A: a clear liquid diet for 12. h on the day before; Group B: high volume polyethylene glycol (50. mL/kg, up to 2. Lt/die); Group C: low volume polyethylene glycol (25. mL/kg up to 1. Lt/die); Group D: 20. mL (376. mg) of oral simethicone; Group E: 25. mL/kg (up to 1. Lt/die) of polyethylene glycol solution plus 20. mL (376. mg) of oral simethicone. Results: Overall, 198 patients (53% male, median age 13 years) were enrolled. Preparation regimen visualization scores were 14.1. ±. 4.2, 18.9. ±. 5.1, 17.8. ±. 5.5, 14.9. ±. 4.8 and 20.9. ±. 4.6 in groups A, B, C, D and E, respectively (P<. 0.01). Positive findings were found in 172 cases (87%), but no significant differences were observed in the diagnostic yield and tolerability. Interobserver agreement, k=0.89 (95% CI 0.83. ±. 0.71). Conclusion: This is the first report in children that supports the use of 25. mL/kg (up to 1. Lt/die) of polyethylene glycol solution plus 20. mL (376. mg) of oral simethicone as the preparation of choice for capsule endoscopy. © 2013 Editrice Gastroenterologica Italiana S.r.l.