The Use of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy

Abstract

Colon capsule endoscopy was approved for reimbursement under the national health insurance system of Japan in 2014. At our hospital, specialized mainly in renal, hepatic, and diabetic diseases, we have been performing colon capsule endoscopy since December 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile intestine, impaired platelet function, or oral administration of nonsteroidalanti inflammatory drugs (NSAIDs) or anticoagulants. For this reason, detailed examination by capsule endoscopy appears to be useful. However, the capsule excretion rate after recommended bowel preparation reportedly ranges from 70% to 90%, and administration of boosters is also necessary. For dialysis patients, liquid loading is a problem. In this study, we evaluated the efficacy of bowel preparation with castor oil for improving the capsule excretion rate. In all 20 patients (including four dialysis patients), both capsule transit time and duration of capsule endoscopy were shortened. The results are presented and briefly discussed in this report.

Clinical Factors Associated with Missing Colorectal Polyp on Colon Capsule Endoscopy

“…In spite of such an idea, if the transit time of capsule is too short, it would be better to perform CS after excretion of capsule endoscopy. Nowadays, Castor oil (Himashi Oil: Yoshida Pharmaceutical, Japan) is preliminarily used for bowel preparation, because it improves the capsule excretion rate and shortens the capsule transit time [19]. In this study, Castor oil was also used in many cases and it contributed to the increase in excretion rate of CCE examinations.…”

Multicenter feasibility study of bowel preparation with castor oil for colon capsule endoscopy

“…We previously reported in a pilot multicenter randomized controlled trial that PEG‐based bowel preparation that was reduced to 3.8 L (range 2.9–4.1 L) achieved adequate colon cleansing level but low capsule excretion rate within its battery life (71%) in apparently healthy Japanese volunteers and patients . Hotta recently reported that bowel preparation with castor oil was effective for improving the capsule excretion rate (100% [20/20] with castor oil vs. 63% [46/73] without) and reducing liquid loading in dialysis patients . Castor oil derived from the castor bean has been used as a safe stimulant laxative for thousands of years.…”

“…6 Hotta recently reported that bowel preparation with castor oil was effective for improving the capsule excretion rate (100% [20/20] with castor oil vs. 63% [46/73] without) and reducing liquid loading in dialysis patients. 7 Castor oil derived from the castor bean has been used as a safe stimulant laxative for thousands of years. Thus, in a multicenter retrospective feasibility study, we determined the effects of castor oil as a booster on CCE excretion rate, liquid loading, endoscopic cleansing level, and accuracy of colorectal polyp detection.…”

Usefulness of Castor Oil for Bowel Preparation for Colon Capsule Endoscopy in the Patients on Dialysis

“…The success rate of completing entire colon observation was 63% in the castor non-dialysis patients). The success rates were 70% in the non-dialysis patients and 54% in the dialysis patients) [8]. Statistically significant differences were observed between patients on Dialysis receiving bowel preparation with and without castor oil (P < 0.001).…”