BOWEL PREPARATION FOR SMALL BOWEL CAPSULE ENDOSCOPY: EFFICACY OF STANDARD REGIMEN WITH LOW VOLUME (2L) PEG VERSUS VERY LOW VOLUME (1L) PEG AND ASCORBATE

Aims ESGE guidelines recommend purgative bowel preparations with 2L of PEG for small bowel capsule endoscopy (SBCE). We have compared the efficacy of a standard formulation of 2L-PEG solution (SELG-ESSE) versus a very low volume solution (1L-PLENVU^​ Macrogol 3350+Sodium ascorbate+sodium sulfate+Ascorbic acid+Electrolytes) already adopted for large bowel preparation.

Methods We arranged a single-centre, retrospective, operator-blind, observational study. Between 10/2020 and 03/2021 all patients undergoing SBCE randomly received 2L-PEG or 1L-PLENVU^​ before SBCE. SBCE visibility was defined adequate or non-adequate by employing a quantitative (0 – 3;≥2 adequate) visibility scoring system for each SB tertile. We defined diagnostic yield as the rate of SBCE with at least one relevant endoscopic finding.

Results Seventy SBCE examinations were analyzed, 40 with 2L-PEG and 30 with 1L-PLENVU^​ . No differences were found in age, gender, adverse event (none), intolerance to the purgative agent (none) and SBCEs indication. We found adequate SBCE visibility in 69/70 examinations (1/70 nonadequate with 2L-PEG). The SB mucosal visibility scored≥2 in all the three SB tertiles in 72.5%(29/40) and in 76.7%(23/30) of SBCEs prepared with 2L-PEG and with 1L-PLENVU^​ respectively (p=0.79). A perfect SBCE visibility (score 9, score 3 in all tertile) was found in 25%(10/40) of patients receiving 2L-PEG and in 20%(6/30) of patients receiving 1L-PLENVU^​ (p=0.78). The diagnostic yield was 62.5%(25/40) in the 2L-PEG group and 63.3%(19/30) in the 1L-PLENVU^​ group (p=1).

Conclusions Our exploratory study suggests that 1L-PLENVU^​ can be as effective as 2L-PEG solution in SBCE preparation in a real-life setting.

Publication History

Article published online:
14 April 2022