Evaluating a combined bowel preparation for small-bowel capsule endoscopy: a prospective randomized–controlled study

Abstract Background Capsule endoscopy (CE) is frequently hindered by intra-luminal debris. Our aim was to determine whether a combination bowel preparation would improve small-bowel visualization, diagnostic yield, and the completion rate of CE. Methods Single-blind, prospective randomized–controlled study of outpatients scheduled for CE. Bowel-preparation subjects ingested 2 L of polyethylene glycol solution the night prior to CE, 5 mL simethicone and 5 mg metoclopramide 20 minutes prior to CE and laid in the right lateral position 30 minutes after swallowing CE. Controls had no solid food after 7 p.m. the night prior to CE and no liquids 4 hours prior to CE. Participants completed a satisfaction survey. Capsule readers completed a small-bowel-visualization assessment. Results Fifty patients were prospectively enrolled (56% female) with a median age of 54.4 years and 44 completed the study (23 patients in the control group and 21 in the preparation group). There was no significant difference between groups on quartile-based small-bowel visualization (all P > 0.05). There was no significant difference between groups in diagnostic yield (P = 0.69), mean gastric (P = 0.10) or small-bowel transit time (P = 0.89). The small-bowel completion rate was significantly higher in the preparation group (100% vs 78%; P = 0.02). Bowel-preparation subjects reported significantly more discomfort than controls (62% vs 17%; P = 0.01). Conclusions Combined bowel preparation did not improve small-bowel visualization but did significantly increase patient discomfort. The CE completion rate improved in the preparation group but the diagnostic yield was unaffected. Based on our findings, a bowel preparation prior to CE does not appear to improve CE performance and results in decreased patient satisfaction (ClinicalTrials.gov, No. NCT01243736).

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Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(04)01879-6 ◽

2004 ◽

Vol 60 (4) ◽

pp. 534-538 ◽

Cited By ~ 103

Author(s):

Nikos Viazis ◽

Spiros Sgouros ◽

Kostis Papaxoinis ◽

John Vlachogiannakos ◽

Christina Bergele ◽

...

Keyword(s):

Capsule Endoscopy ◽

Bowel Preparation ◽

Diagnostic Yield ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled

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Su1544 Assessment of Combined Bowel Preparation for Capsule Endoscopy: a Prospective Randomized Controlled Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.288 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB316 ◽

Cited By ~ 1

Author(s):

Stephanie L. Hansel ◽

Christopher J. Gostout ◽

Joseph a. Murray ◽

Jeffrey a. Alexander ◽

David H. Bruining ◽

...

Keyword(s):

Capsule Endoscopy ◽

Bowel Preparation ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled

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Effects of a randomized controlled study on the behaviors of overweight schoolchildren

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.26e0221 ◽

2021 ◽

Vol 26 ◽

Author(s):

Anastácio Neco de Souza Filho ◽

Thaynã Alves Bezerra ◽

Paulo Felipe Ribeiro Bandeira ◽

Luciana Gatto Azevedo Cabral ◽

José Fernando Vila Nova de Moraes ◽

...

Keyword(s):

Physical Activity ◽

Behavioral Therapy ◽

Vigorous Physical Activity ◽

Randomized Controlled Study ◽

Controlled Study ◽

Control Group ◽

Daily Routine ◽

Randomized Controlled ◽

School Based ◽

Significant Difference

This study aimed to determine the effects of a school-based multi-component intervention on accelerometer- measured physical activity (PA) and sedentary behavior (SB) in schoolchildren overweight. This is a randomized controlled study with overweight schoolchildren, allocated to experimental group (EG; n = 13; 7.6 ± 0.8 years; 42.9% boys) and control group (CG; n = 17; 8.2 ± 0.9 years; 26.7% boys). The EG was submitted to a 10-week school-based intervention, comprised of PA and psychological sessions (behavioral therapy), and nutritional guidance. The CG followed the daily routine of life. The time of PA and SB were measured using accelerometers used for seven days. To compare mean SB, moderate to vigorous physical activity (MVPA) and total physical activity (TPA), generalized estimation equations (GEE) were used. It was observed that the average time in MVPA and TPA increased significantly in EG at the weekend (+ 40.9 min / day, p < 0.001; and + 51.6 min/day, p = 0.035, respectively) and at full week (+ 62.9 min/day, p < 0.001; and + 225.0 9 min/day, p = 0.038, respectively). There was no significant difference in time spent in SB after the intervention in both groups. Thus, it was concluded that the proposed school-based multicomponent intervention was effective in increasing levels of MVPA and TPA in overweight schoolchildren. This finding can optimize future interventions to promote a healthy lifestyle for schoolchildren in the school environment.

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Effectiveness of polaprezinc for low-dose aspirin-induced small-bowel mucosal injuries as evaluated by capsule endoscopy: a pilot randomized controlled study

BMC Gastroenterology ◽

10.1186/1471-230x-13-108 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 27

Author(s):

Ikue Watari ◽

Shiro Oka ◽

Shinji Tanaka ◽

Taiki Aoyama ◽

Hiroki Imagawa ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Low Dose ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled ◽

Dose Aspirin ◽

Low Dose Aspirin

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Evaluation of Different Bowel Preparations for Small Bowel Capsule Endoscopy: A Prospective, Randomized, Controlled Study

Digestive Diseases and Sciences ◽

10.1007/s10620-011-1693-z ◽

2011 ◽

Vol 56 (10) ◽

pp. 2900-2905 ◽

Cited By ~ 31

Author(s):

Vicente Pons Beltrán ◽

Begoña González Suárez ◽

Cecilia González Asanza ◽

Enrique Pérez-Cuadrado ◽

Servando Fernández Diez ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled ◽

Bowel Preparations

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Effectiveness of Improved Use of Chewing Gum During Capsule Endoscopy in Decreasing Gastric Transit Time: A Prospective Randomized Controlled Study

Frontiers in Medicine ◽

10.3389/fmed.2021.605393 ◽

2021 ◽

Vol 8 ◽

Author(s):

Liang Huang ◽

Yue Hu ◽

Fang Chen ◽

Shan Liu ◽

Bin Lu

Keyword(s):

Small Bowel ◽

Transit Time ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Controlled Study ◽

Chewing Gum ◽

Control Group ◽

Completion Rates ◽

Patients Âgés ◽

Gastric Transit Time

Background/Aim: Chewing gum throughout small bowel capsule endoscopy (SBCE) increases completion rates (CRs) but decreases small bowel transit time (SBTT) and diagnostic yield (DY). We determined the effects of chewing gum early during SBCE on gastric transit time (GTT), SBTT, CR, DY, and gastroscopy intervention.Methods: We prospectively enrolled patients (ages 16–80 years) undergoing SBCE between January and June 2019. Patients were randomized to a chewing gum group (103 patients) and a control group (102 patients). Patients in the former group chewed one piece of gum for ~15 min every 30 min during the first hour of SBCE. Two gastroenterologists blinded to the study group examined the data.Results: GTT was shorter in the chewing gum group (19.0 min, interquartile range: 17.0–52.0 min) than in the control group [42.5 min (23.25–60 min); P = 0.01]. SBTT was similar in the two groups [318.5 min (239.5–421.3 min) vs. 287.0 min (216.0–386.0 min); P = 0.08]. Gastroscopy rate was lower in the chewing gum group (15.53 vs. 32.35%, P = 0.005). CR (95.15 vs. 89.22%, P = 0.114) and DY (66.02 vs. 59.80%, P = 0.359) did not differ between the groups. The number of abnormal-lesion types detected per patient was higher in the chewing gum group [1.0 (0.0–2.0) vs. 2.0 (0.0–2.0); P = 0.049].Conclusions: Chewing gum early during SBCE significantly reduced GTT and gastroscopy intervention, with no influence on SBTT (Trial number: NCT03815136).

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AB1309-HPR EFFICACY OF ADDING CAFFEINE TO THE TREATMENT REGIMEN IN REDUCING METHOTREXATE INTOLERANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A RANDOMIZED CONTROLLED STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1887 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1945.1-1945

Author(s):

A. Fehr ◽

F. El Noby ◽

N. Fathi ◽

R. Lotfy

Keyword(s):

Rheumatoid Arthritis ◽

Severity Score ◽

Randomized Controlled Study ◽

Controlled Study ◽

Control Group ◽

Base Line ◽

Clinical Rheumatology ◽

Randomized Controlled ◽

Significant Difference

Background:Rheumatoid arthritis is one of common form of chronic inflammatory arthritis. Methotrexate has remained anchor treatment because of its potent efficacy1. Intolerance to Methotrexate is a common cause of non-compliance2&3.Objectives:To investigate the effect of adding caffeine orally as Methylxanthines (Caffeine), act as adenosine receptor antagonists4to reduce symptoms of moderate to severe methotrexate intolerance in patients with Rheumatoid Arthritis5.Methods:A prospective, randomized controlled study conducted at Aswan University Hospital, Egypt from Jan 2018 till may 2019. Sixty patients with Rheumatoid arthritis who have had experienced moderate to severe methotrexate intolerance was enrolled in the study. The methotrexate intolerance severity score (MISS)6was evaluated at base line before initiation of study then at the next three months consecutively. Patients were randomly assigned by closed envelope method into 2 groups each containing 30 patients:Group (A); 30 patients was prescribed caffeine (coffee or dark chocolate) as an antidote to methotrexate intolerance7.Group (B); 30 matched patients acted as control group that included who will continue methotrexate regimen without addition of any extra caffeine.Results:Twenty four patients (80%) at time three follow up visit showed full improvement of symptoms of methotrexate-intolerance compared to ten patients (33.3%) at 2nd month follow up visit and seven patients (23%) at 1st month follow up visit with statistically significant difference all over the study period (P=0.005). half of study group patients discontinued anti-emetic and other drugs while none in control group did.Conclusion:Adding caffeine to management regimen can reduce the symptoms of severe methotrexate-intolerance in Rheumatoid Arthritis patients.References:[1]Friedman, B., & Cronstein, B. (2019). Methotrexate Mechanism in Treatment of Rheumatoid Arthritis. Joint Bone Spine, 86(3):301-307[2]Wang, W., Zhou, H., & Liu, L. (2018). Side effects of methotrexate therapy for rheumatoid arthritis: a systematic review. European journal of medicinal chemistry. Volume 158, 502-516[3]Bulatović, M., Heijstek, M. W., Verkaaik, M., van Dijkhuizen, E. P., Armbrust, W., Hoppenreijs, E. P., ... & Rademaker, C. M. (2011). High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: development and validation of a methotrexate intolerance severity score. Arthritis & Rheumatism, 63(7), 2007-2013.[4]Malaviya, A., Baghel, S., Verma, S., Thakran, R., & Messi, C. (2019). Use of coffee for alleviating methotrexate intolerance in rheumatic diseases. Indian Journal of Rheumatology, 14(1), 79-79.[5]Ribeiro, J. A., & Sebastiao, A. M. (2010). Caffeine and adenosine. Journal of Alzheimer’s Disease, 20(s1), S3-S15.[6]Fatimah, N., Salim, B., Nasim, A., Hussain, K., Gul, H., & Niazi, S. (2016). Frequency of methotrexate intolerance in rheumatoid arthritis patients using methotrexate intolerance severity score (MISS questionnaire). Clinical rheumatology, 35(5), 1341-1345.[7]Malaviya, A. N. (2017). Methotrexate intolerance in the treatment of rheumatoid arthritis (RA): effect of adding caffeine to the management regimen. Clinical rheumatology, 36(2), 279-285.Disclosure of Interests:None declared

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Polyethylene Glycol for Small Bowel Capsule Endoscopy

Gastroenterology Research and Practice ◽

10.1155/2017/7468728 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Li Yang ◽

Xiao Wang ◽

Tao Gan ◽

Yiping Wang ◽

Jinlin Yang

Keyword(s):

Polyethylene Glycol ◽

Small Bowel ◽

Image Quality ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Assessment Instrument ◽

Control Group ◽

Significant Difference

Capsule endoscopy has been the first-line examination for small bowel diseases, yet its diagnostic yield is restricted by unsatisfactory bowel preparation. To evaluate the clinical effectiveness of different dosages of polyethylene glycol in patients undergoing capsule endoscopy, we performed a comprehensive meta-analysis of all randomized controlled trials involving polyethylene glycol in preparation for capsule endoscopy. The methodological quality of the trials was evaluated using the Cochrane Risk of Bias assessment instrument. In this study, 12 RCTs involving 2072 patients were included in this review. Our review indicated that 4 L and 2 L polyethylene (PEG) before capsule endoscopy (CE) and 500 mL PEG after CE increase the small bowel image quality, whereas 1 L PEG did not improve the small bowel image quality. PEG accelerated the gastric emptying time. There was no significant difference between the PEG group and control group in small bowel transit time, completion rates, and diagnostic yield.

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