Clinical utility of purgative bowel preparation before capsule endoscopy: a multicenter, blinded, randomized controlled trial.
Gastrointest Endosc
; 96(5): 822-828.e1, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-35843287
ABSTRACT
BACKGROUND AND AIMS:
Optimal bowel preparation before capsule endoscopy (CE) is currently unknown. In this multicenter, blinded, randomized controlled trial, we assessed clinical effectiveness of 2 types of purgative regimen and a control arm of clear fluid only.METHODS:
Patients with suspected small intestinal bleeding were randomized into 3 arms arm A, clear fluids only for 18 hours before CE and simethicone 200 mg in 150 mL water immediately before CE; arm B, same as A + 2 L of polyethylene glycol (PEG) 12 hours before CE; and arm C, same as A + 1 L PEG + sodium ascorbate 3 hours before CE. To assess diagnostic yield, lesions were classified either as highly relevant (P2) or less relevant (P0 or P1) lesions. Small-bowel visualization quality (SBVQ) was assessed using the Brotz score. Patient tolerability was assessed using the visual analog scale (0-10, with lower scores indicating better tolerability).RESULTS:
Two hundred twenty-nine patients completed the study. The mean age was 58.7 years (95% confidence interval, 29.3-87.9), and 47.2% were men. There was no significant difference in diagnosis of P2 lesions in arms A, B, and C (48.7%, 48.0%, and 45.9%, respectively; P = .94). Overall SBVQ and distal SBVQ were similar across the 3 arms (P = .94 and P = .68, respectively). Patients reported better tolerability in arm A (mean score, 1.5) compared with arms B and C (mean score, 3.5 and 2.6, respectively; P < .001).CONCLUSIONS:
The use of a purgative bowel preparation before CE does not improve diagnostic yield or small-bowel visualization and is associated with lower patient tolerance. (Clinical trial registration number ACTRN 12614000883617.).
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Endoscopia por Cápsula
Tipo de estudo:
Clinical_trials
Limite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália