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Video capsule endoscopy: is bowel preparation necessary?
  1. Carmine Catalano1,
  2. Rafael Antonio Ching Companioni2,
  3. Pouya Khankhanian3,4,
  4. Neil Vyas1,
  5. Ishan Patel1,
  6. Raghav Bansal2,
  7. Aaron Walfish2
  1. 1Department of Internal Medicine, Icahn School of Medicine at Mount Sinai (Elmhurst Program), Elmhurst Hospital Center, Elmhurst, New York, USA
  2. 2Department of Gastroenterology, Icahn School of Medicine at Mount Sinai (Elmhurst Program), Elmhurst Hospital Center, Elmhurst, New York, USA
  3. 3Center for Neuroengineering and Therapeutics, University of Pennsylvania, Pennsylvania, USA
  4. 4Department of Neurology, University of Pennsylvania, Pennsylvania, USA
  1. Correspondence to Dr Carmine Catalano, Department of Internal Medicine, Icahn School of Medicine at Mount Sinai (Elmhurst Program), Elmhurst Hospital Center, 79-01 Broadway, Elmhurst, New York, NY 11373, USA; Carmine.Catalano13{at}gmail.com

Abstract

There is no standardized protocol for bowel preparation prior to video capsule endoscopy, although one is strongly recommended. The purpose of our study was to see if there was a statistical significance between small bowel mucosal visualization rates for those who received bowel preparation and those who did not. We retrospectively analyzed all patients who had a video capsule endoscopy from August 2014 to January 2016 at a tertiary care center. All patients fasted prior to the procedure. Bowel preparation when used consisted of polyethylene glycol. A long fast consisted of 12 or more hours. The grading system used to assess the small bowel was adapted from a previously validated system from Esaki et al. Statistical analyses were performed using Fisher's exact test or Welch's 2-sample t-test and statistical significance was present if the p value was ≤0.05. 76 patients were carried forward for analysis. Small bowel mucosal visualization rates were similar between those who received bowel preparation and those who did not (92.5% vs 88.9%, p=0.44). Small bowel mucosal visualization rates were significantly better in those patients who had a long fast compared with those who had a short fast (97.7% vs 81.3%, p=0.019). Our study demonstrates that the addition of bowel preparation prior to video capsule endoscopy does not significantly improve small bowel mucosal visualization rates and, in addition, there is a statistically significant relationship between increased fasting time and improved small bowel mucosal visualization. A prolonged fast without bowel preparation might be satisfactory for an adequate small bowel visualization but further randomized, prospective studies are necessary to confirm these findings.

  • Gastrointestinal Contents
  • Intestines
  • Endoscopy

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