A Single-Center Randomized Controlled Trial Evaluating Timing of Preparation for Capsule Enteroscopy

Abstract

Background/AimsIntestinal lavage (IL) administration immediately before capsule enteroscopy (CE) is superior to lavage the day before the procedure. We aimed to determine the effect of IL timing on CE diagnostic yield.MethodsPatients referred for CE were randomized prospectively into two equal groups according to the timing of IL with 2 L of polyethylene glycol solution. Group A and B underwent IL over 2 hours beginning 14 and 4 hours, respectively, before the scheduled CE. The primary outcome measure was preparation quality, measured with a predetermined validated grading scale.ResultsA total of 34 patients were randomized. The frequency of mucosal abnormalities (77% vs. 82%, p=not significant [NS]) and diagnostic yield (47% vs. 53%, p=NS) were similar between the two groups. Moreover, no significant association between the quality of small bowel preparation and the timing at which the purgative for IL was administered was observed (overall fluid transparency, p=0.936; overall mucosal invisibility, p=0.091).ConclusionsDay-before IL is equivalent to same-day IL in terms of overall preparation quality, proportion of complete studies to cecum, small bowel transit time, frequency of identified mucosal abnormalities, and overall diagnostic yield.

Optimal Bowel Preparation for Video Capsule Endoscopy

“…To date, there has been no consensus regarding optimal timing of bowel preparation for VCE. To evaluate optimal timing of VCE bowel preparation, a single-center randomized controlled trial was conducted by Black et al [ 18 ]. However, there was no significant difference between the quality and timing (day before VCE versus 4 hours prior to VCE) of small bowel preparation.…”

Quality Indicators for Small Bowel Capsule Endoscopy

“…Therefore, the timing of bowel preparation is frequently dependent on the time of colonoscopic examination. According to a single center study by Black et al, [ 41 ] there was no significant difference of diagnostic yield, and the quality according to timing of SB preparation (14 hours vs. 4 hours prior to the CE). The day before bowel preparation showed similar results to the same-day bowel preparation regarding quality, SB transit time, cecal completion rate, and overall diagnostic yield.…”

What Is the Optimal Timing of Bowel Preparation for Video Capsule Endoscopy?

“…Black et al 5 conducted a single-center randomized controlled trial evaluating preparation for VCE. Thirty-four patients were randomized prospectively into two equal groups according to the timing of intestinal lavage (2 L of PEG).…”

“…However, there was no significant difference between the two groups (day-before VCE vs. 4 hours prior to VCE) in this study. 5 …”