Bowel preparations for capsule endoscopy: a comparison between simethicone and magnesium citrate

• Published in: Gastrointestinal endoscopy Vol. 69; no. 1; pp. 94 - 101
• Main Authors: Esaki, Motohiro, MD, Matsumoto, Takayuki, MD, Kudo, Tetsuji, MD, Yanaru-Fujisawa, Ritsuko, MD, Nakamura, Shotaro, MD, Iida, Mitsuo, MD
• Format: Journal Article
• Language: English
• Published: Maryland heights, MO Mosby, Inc 2009; Elsevier
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Capsule Endoscopy - methods; Citric Acid - administration & dosage; Cohort Studies; Digestive system. Abdomen; Dose-Response Relationship, Drug; Drug Administration Schedule; Endoscopy; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Image Enhancement; Intestinal Diseases - diagnosis; Intestine, Small; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Organometallic Compounds - administration & dosage; Patient Compliance; Premedication; Retrospective Studies; Sensitivity and Specificity; Simethicone - administration & dosage; Therapeutic Irrigation - methods; Young Adult; polyethylene glycol; CE; GTT; sodium phosphate; SBTT; small-bowel transit time; capsule endoscopy; gastric transit time; obscure GI bleeding; PEG; OGIB; reporting and processing of images and data; NaP; RAPID; Citrate; Magnesium; Capsule endoscopy; Inorganic element; Comparative study
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2008.04.054

Background Bowel preparation for capsule endoscopy (CE) has not been standardized. Objective This study aimed to compare CE images between patients prepared by simethicone and those prepared by magnesium citrate. Design Retrospective analysis of case series of our hospital from 2004 to 2007. Setting Single center. Patients and Interventions CE images of 75 patients receiving bowel preparation either by 200 mg of simethicone (n = 39) or by 34 g of magnesium citrate (n = 36) were retrospectively investigated. Grades of fluid transparency and mucosal invisibility by air bubbles and food residue were compared between the 2 preparations. Capsule transit time, frequency of positive findings, and interobserver variations between 2 observers were also investigated. Main Outcome Measurements Image quality and diagnostic yield of CE. Results Fluid transparency in the first and the third time segments of the small intestine was better in patients prepared by magnesium citrate than in those prepared by simethicone ( P = .001 and P = .03, respectively). On the other hand, mucosal invisibility was not different in any part of the small intestine between the 2 groups. Neither gastric transit time nor small-bowel transit time was different between the 2 groups. The diagnostic yield of CE correlated significantly with fluid transparency ( P = .04), but it did not correlate with mucosal invisibility. Limitations Single-center retrospective study. Conclusion Magnesium citrate seems to be a recommended preparation for CE compared with simethicone. The fluid transparency, rather than the mucosal invisibility, may be a factor associated with the diagnostic yield of CE.