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

摘要

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.