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Low‐dose and same day use of polyethylene glycol improves image of video capsule endoscopy: A multi‐center randomized clinical trial
Author(s) -
Wu Shan,
Zhong Liang,
Zheng Ping,
Wang YuGang,
Ding WeiQun,
Yu Qi,
Hui PingPing,
Chen HuiMin,
Gao YunJie,
Ge ZhiZheng
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14899
Subject(s) - medicine , peg ratio , capsule endoscopy , randomized controlled trial , capsule , polyethylene glycol , clinical endpoint , group b , gastroenterology , group a , bowel preparation , surgery , colonoscopy , nuclear medicine , botany , colorectal cancer , finance , cancer , chemical engineering , engineering , economics , biology
Background and Aim Clear visualization of the small bowel is a requirement for satisfactory video capsule endoscopy (VCE). The aim of this study was to identify the optimal dose and timing of polyethylene glycol (PEG) for small bowel preparation before VCE. Methods A total of 410 patients were enrolled in this prospective randomized trial. All patients fasted for 12 h and ingested 320 mg simethicone 30 min before swallowing the capsule. Patients were randomized into five groups: Group A (no PEG), Group B (1‐L PEG, 12 h before VCE), Group C (2‐L PEG, 12 h before VCE), Group D (1‐L PEG, 4 h before VCE), and Group E (2‐L PEG, 4 h before VCE). The primary endpoint was small bowel visualization quality (SBVQ), and the secondary endpoints were patient acceptability and diagnosis rate of VCE. Results Excellent SBVQ was achieved in 27 (32.5%) of Group A, 38 (46.3%) of Group B, 40 (48.2%) of Group C, 55 (66.3%) of Group D, and 43 (54.4%) of Group E. The percentage of excellent SBVQ in Group D was significantly more than in Group A (66.3% vs 32.5%, P < 0.001), and diagnostic rate in the distal segment was higher (28.9% vs 10.8%, P = 0.0035). Patient acceptance of 1‐L PEG was better than of 2‐L PEG ( P < 0.005). Conclusion Small bowel cleansing with 1‐L PEG given 4 h before VCE was the optimal preparation for visualization of the bowel and patient acceptance ( ClinicalTrials.gov , ID: NCT02486536).