Bowel Preps Before Capsule Endoscopy

The patients were prospectively randomized into two groups. Group A fasted at leasteight hoursbefore the examination; group B received additional Prepacol. Capsule endoscopy films were evaluated by three independent, endoscopically experienced investigators who were blinded concerning the kind of preparation. The following parameters were assessed: total quality of the film, visibility of small bowel mucosa, velocity of the capsule and occurrence of foam, air and residual food. Every parameter was graded from 1 to 4, as excellent, good, limited and poor quality. Preparation with Prepacol accelerated small bowel transit time, but had no effect on the different parameters of CE quality. In the view of the authors, the investigated combination of sodium phosphate and bisacodyl is an inappropriate preparation for CE. Because CE is an expensive and time-consuming examination, an effective preparation is essential to minimize false results at the best possible rate. Further studies considering the patient's compliance, which might be reduced by the taste of the preparation, are necessary to identify sufficient preparation procedures. Reference Franke A, Hummel F, Knebel P, Antoni C, Bocker U, Singer MV, Lohr M. Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy. more hints

Capsule endoscopy

However, there is a paucity of data concerning the clinical impact of CE in small bowel malignancies. A single study published earlier this year evaluated the effectiveness of CE in diagnosing small bowel tumours. Authors undertook a retrospective analysis of the charts of 562 patients who underwent CE for a variety of indications from August 2001 to November 2003. A diagnosis was made by capsule endoscopy in 277 patients (49.3%). Of 562 patients who were included in the study, 50 patients (8.9%) were diagnosed with small bowel tumours, including eight adenocarcinomas (1.4%), 10 carcinoids (1.8%), four gastrointestinal stromal tumours (0.7%), five lymphomas (0.9%), three inflammatory polyps, one lymphangioma, one lymphangioectasia,one hemangioma, one hamartoma, and one tubular adenoma. Of the tumours diagnosed, 48% were malignant. It was observed that nine of 67 patients (13%) younger than 50 years who underwent CE for obscure bleeding had small bowel tumours. The pathology results were not available for 10 patients. CE diagnosed small bowel tumours in 8.9% of patients who underwent the procedure, establishing it as an effective diagnostic modality. These findings suggest an important role for CE in the algorithm for the diagnostic work-up of patients with suspected small bowel lesions, potentially leading to earlier detection and treatment of small bowel tumours and an improved prognosis for patients with these neoplasms. Conclusion CE is a non-invasive and painless procedure that has demonstrated a good diagnostic yield in patients with obscure gastrointestinal bleeding and known or suspected Crohn's disease, and that is showing promise in the identification of small bowel tumours. The superiority of CE over existing diagnostic modalities, most notably in OGIB, is such that it is likely to become the procedure of choice in the evaluation of patients with obscure bleeding and suspected CD. Indications for the procedure continue to evolve and promising new applications are ongoing, expanding the scope of CE in evaluation of the oesophagus and colon. other stuff