*Institute for Digestive Research, Digestive Disease Center, Soon Chun Hyang University Hospital, Seoul, Korea.
†Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
‡Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
§Department of Internal Medicine, Chungang University College of Medicine, Seoul, Korea.
∥Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
¶Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea.
#Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea.
**Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
††Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations.
A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure.
Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups.
Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.