Optimal preparation for small bowel examinations with video capsule endoscopy

BackgroundVideo capsule endoscopy is a major advance for small bowel exploration. Although the clinical benefit is well accepted, there are still unresolved issues concerning patient preparation.AimThis study was set up in order to clarify the clinical benefit of small bowel preparation and give advices in order to obtain the best results for this expensive device.Method116 patients were randomised in 3 centres between two preparations from the traditional liquid diet versus polyethylene glycol colonoscopy-like preparation. External viewer monitoring and recording pictures were focused on image quality, bubbles or diet residues. Picture qualities were assessed blindly.ResultsFor jejunal exploration no differences were noticed between the two preparations but for the ileum, polyethylene glycol preparation gives significant better results than liquid diet: air bubbles (64.4% versus 29.8% p < 0.05); opaque residue (83.1% versus 38.6% p < 0.05). External viewer was useful in order to use prokinetic drugs in case of delayed gastric emptying.ConclusionThe result leads to a new advice for colleagues in handling patients in order to improve the diagnosis yield by using a modified polyethylene glycol preparation.