Clin Endosc.
2025 Mar;58(2):285-290. 10.5946/ce.2024.097.
Bowel preparation for small bowel capsule endoscopy: standard regimen with 2 L polyethylene glycol versus 1 L polyethylene glycol plus ascorbate
- Caccia R
1 - Rimondi A1
- Elli L1,2
- Topa M1
- Cavallaro F2
- Gentile C1
- Scaramella L2
- Nandi N1
- Sidhu R3,4
- Eidler P1
- Vecchi M1,2
- Tontini GE1,2
- Affiliations
-
- 1Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 2Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- 3Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
- 4Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- KMID: 2566149
- DOI: http://doi.org/10.5946/ce.2024.097
Abstract
- Background/Aims
Optimization of bowel preparation for small bowel capsule endoscopy (SBCE) is debated. Guidelines recommend 2 L of iso-osmolar polyethylene glycol (PEG) to improve SBCE visibility. We compared the efficacy of the standard 2 L PEG solution with a 1 L PEG plus ascorbate (PEG-ASC) preparation, which has already been established for large-bowel preparation.
Methods
Between October 2020 and February 2022, patients undergoing SBCE were assigned to receive 2 L PEG or 1 L PEG-ASC bowel preparation on an even- or odd-day basis. Bowel cleanliness was evaluated using the small bowel mucosal visibility scoring system (SBMVSS).
Results
Following propensity score matching using a random forest method, two comparable populations of patients treated with 2 L PEG (n=74, male 41%, 53±17 years) and 1 L PEG-ASC (n=74, male 42%, 55±21 years) were obtained from the original cohort of 221 consecutive SBCE patients. Our results showed a trend towards more frequent adequate mucosal visibility with 1 L PEG-ASC compared to 2 L PEG (small bowel mucosal visibility ≥2 in all three small bowel tertiles, p=0.07), as per the SBMVSS score. No significant differences were observed in the diagnostic yield (p=1.00), visibility score=9 (p=0.85), SBCE completeness (p=0.33), or adequate mucosal visibility in each tertile (p=0.61, p=0.74, and p=0.70 for the first, second, and third tertiles, respectively).
Conclusions
Our study suggests the non-inferiority of the 1 L PEG-ASC solution over the standard 2 L PEG for SBCE preparation.
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