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Effect of Different Modalities of Purgative Preparation on the Diagnostic Yield of Small Bowel Capsule for the Exploration of Suspected Small Bowel Bleeding: A Multicenter Randomized Controlled Trial

Digestive Endoscopy Unit of HEGP, APHP, Paris, France. Gastroenterology Department, University Hospital of Brest, Brest, France. Gastroenterology Department, Cochin, APHP, Paris. Gastroenterology and Nutrition, University Hospital Nice L'Archet Hospital, Nice, France. Gastroenterology Department, Hospital Saint Philbert, Lomme, France. Gastroenterology Department, Hospital of Avignon, Avignon, France. Gastroenterology Department, Hospital of Saint-Brieuc, Saint Brieuc, France. Inserm CIC 1412-Brest Medical University Hospital, Brest, France. Gastroenterology Department, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.

The American journal of gastroenterology. 2022
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Abstract
INTRODUCTION The aim of our study was to compare clear liquid diet with 2 different polyethylene glycol (PEG)-based bowel preparation methods regarding diagnostic yield of small bowel capsule endoscopy (SBCE) in patients with suspected small bowel bleeding (SBB). METHODS In this prospective multicenter randomized controlled trial, consecutive patients undergoing SBCE for suspected SBB between September 2010 and February 2016 were considered. Patients were randomly assigned to standard regimen, that is, clear fluids only (prep 1), standard regimen plus 500 mL PEG after SBCE ingestion (prep 2), or standard regimen plus 2 L PEG plus 500 mL PEG after SBCE ingestion (prep 3). The primary outcome was the detection of at least one clinically significant lesion in the small bowel. The quality of small bowel cleansing was assessed. A questionnaire on the clinical tolerance was filled by the patients. RESULTS We analyzed 834 patients. No significant difference was observed for detection of P1 or P2 small bowel lesions between prep1 group (40.5%), prep 2 group (40.2%), and prep 3 group (38.5%). Small bowel cleansing was improved in prep 2 and 3 groups compared with that in prep 1 group. Compliance to the preparation and tolerance was better in prep 2 group than in prep 3 group. DISCUSSION Small bowel purgative before SBCE allowed better quality of cleansing. However, it did not improve diagnostic yield of SBCE for suspected SBB.
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Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine