Optimal Bowel Preparation for Video Capsule Endoscopy

Abstract

During video capsule endoscopy (VCE), several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG-) based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE.

Predictive factors of an incomplete examination and inadequate small-bowel cleanliness during capsule endoscopy

“…Nevertheless, small-bowel preparation with 2L of polyethylene glycol before CE seems to improve the quality of mucosa visualization and the diagnostic yield. There are no differences regarding the CE completion rate, GTT and SBTT (12,33,34). In our study, 41.6% (n = 54) of CE were classified as poor-fair, which may be explained by the enteric preparation used (fasting and a liquid diet the day before the procedure).…”

Clear Liquids versus Polyethylene Glycol Preparation for Video Capsule Endoscopy of the Small Bowel: A Randomized Controlled Trial

“…We opted to examine both 2 and 4 L PEG preparations, given its widespread use in the United States. Some studies have shown that 2 L of PEG may be adequate for small bowel visualization in VCE [26]. However, current guidelines indicate that a full or partial bowel preparation may be used prior to VCE [17]; therefore, we opted to study both a 2 and 4 L PEG bowel preparation.…”

Capsule endoscopy for small‐intestinal disorders: Current status

“…Korean guidelines released in 2013 stated that preparation with PEG solution enhanced the SBVQ and also DY, but it did not affect the CR . A more recent meta‐analysis and systematic review concluded that preparation with PEG enhanced the SBVQ only, and did not affect the CR or DY. Yung et al .…”