Are bowel purgatives and prokinetics useful for small-bowel capsule endoscopy? A prospective randomized controlled study.
Gastrointest Endosc
; 69(6): 1120-8, 2009 May.
Article
em En
| MEDLINE
| ID: mdl-19152909
ABSTRACT
BACKGROUND:
Capsule endoscopy (CE) is limited by incomplete small-bowel transit and poor view quality in the distal bowel. Currently, there is no consensus regarding the use of bowel purgatives or prokinetics in CE.OBJECTIVE:
To evaluate the usefulness of bowel purgatives and prokinetics in small-bowel CE.DESIGN:
Prospective single-blind randomized controlled study.SETTING:
Academic endoscopy unit. PATIENTS A total of 150 patients prospectively recruited. INTERVENTION Patients were randomized to 1 of 4 preparations "standard" (fluid restriction then nothing by mouth 12 hours before the procedure, water and simethicone at capsule ingestion [S]); "standard" + 10 mg oral metoclopramide before the procedure (M); Citramag + senna bowel-purgative regimen the evening before CE (CS); Citramag + senna + 10 mg metoclopramide before the procedure (CSM). MAIN OUTCOME MEASUREMENTS Gastric transit time (GTT) and small-bowel transit time (SBTT), completion rates (CR), view quality, and patient acceptability. SECONDARY OUTCOMEMEASURES:
positive findings, diagnostic yield.RESULTS:
No significant difference was noted among groups for GTT (median [minutes] M, CS, and CSM vs S 17.3, 24.7, and 15.1 minutes vs 16.8 minutes, respectively; P = .62, .18, and .30, respectively), SBTT (median [minutes] M, CS, and CSM vs S 260, 241, and 201 vs 278, respectively; P = .91, .81, and .32, respectively), or CRs (85%, 85%, and 88% vs 89% for M, CS, and CSM vs S, respectively; P = .74, .74, and 1.00, respectively). There was no significant difference in view quality among groups (of 44 38, 37, and 40 vs 37 for M, CS, and CSM, vs S, respectively; P = .18, .62, and .12, respectively). Diagnostic yield was similar among the groups. CS and CSM regimens were significantly less convenient (P < .001), and CS was significantly less comfortable (P = .001) than standard preparation.CONCLUSIONS:
Bowel purgatives and prokinetics do not improve CRs or view quality at CE, and bowel purgatives reduce patient acceptability.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Extrato de Senna
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Simeticone
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Trânsito Gastrointestinal
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Catárticos
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Ácido Cítrico
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Endoscopia por Cápsula
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Motilidade Gastrointestinal
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Enteropatias
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Intestino Delgado
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Magnésio
Tipo de estudo:
Clinical_trials
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Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Reino Unido