The Use Of Bowel Preparation to Improve Diagnostic Yield in Small Bowel Capsule Endoscopy. A Prospective Randomised Nested Case Control Study Of Moviprep Versus Dietary Measures

Aims During small bowel capsule endoscopy (SBCE) several factors such as air bubbles, food residue and delayed small bowel transit time can influence optimal visualization. ESGE recommends a Polyethylene glycol-based purgative for better visualisation. However, evidence relating to completion rates and diagnostic yield is still inconclusive and the optimal timing for purgative use remains to be established.

Aim To assess the effect of the addition of Moviprep to dietary manipulation and fasting in a real-world population.

Methods A prospective randomised nested case control study of unselected SBCE subjects presenting for elective outpatient capsule procedures to our unit. Patients were randomised to receive 1L of Moviprep on the evening prior to the study, in addition to our standard protocol of dietary manipulation. Procedures were all performed in the morning following an overnight fast, using Medtronic SB3 capsules. Readers were blinded to the preparation group. Age and gender matched controls were identified from our data-base and included in a 3:1 ratio for analysis. Basic demographics, procedure outcomes and preparation quality were recorded. Preparation quality was graded as good, adequate or sub-optimal.

Results 140 patients have been analysed to date; 35 Movicol subjects, (46 % male, mean age 54 years) and 105 matched controls. Preparation quality was similar being good or adequate in 91 % and 90 % in the Moviprep and control groups respectively. Procedure outcomes were also similar in the Moviprep and Control groups; small bowel transit times 212.9 vs 228.3 minutes and completion rates 94.3 % vs 96.3 %. Importantly there was no statistical difference in reported clinically significant findings 34.29 % vs 32.5 %. Approximately 10 % of procedures in both groups had some areas of poor visualisation described.

Conclusions The addition of 1L Moviprep, the evening before SBCE, provided no improvement in overall preparation quality or diagnostic yield. Further research into optimal small bowel preparation for capsule endoscopy is required.

Citation O’Hara F, Seminov S, McNamara D eP105 THE USE OF BOWEL PREPARATION TO IMPROVE DIAGNOSTIC YIELD IN SMALL BOWEL CAPSULE ENDOSCOPY. A PROSPECTIVE RANDOMISED NESTED CASE CONTROL STUDY OF MOVIPREP VERSUS DIETARY MEASURES. Endoscopy 2021; 53: S131.

Publication History

Article published online:
19 March 2021