| Are bowel purgatives and prokinetics useful for small-bowel capsule endoscopy? A prospective randomized controlled study. | |
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MedLine Citation:
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PMID: 19152909 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Capsule endoscopy (CE) is limited by incomplete small-bowel transit and poor view quality in the distal bowel. Currently, there is no consensus regarding the use of bowel purgatives or prokinetics in CE. OBJECTIVE: To evaluate the usefulness of bowel purgatives and prokinetics in small-bowel CE. DESIGN: Prospective single-blind randomized controlled study. SETTING: Academic endoscopy unit. PATIENTS: A total of 150 patients prospectively recruited. INTERVENTION: Patients were randomized to 1 of 4 preparations: "standard" (fluid restriction then nothing by mouth 12 hours before the procedure, water and simethicone at capsule ingestion [S]); "standard" + 10 mg oral metoclopramide before the procedure (M); Citramag + senna bowel-purgative regimen the evening before CE (CS); Citramag + senna + 10 mg metoclopramide before the procedure (CSM). MAIN OUTCOME MEASUREMENTS: Gastric transit time (GTT) and small-bowel transit time (SBTT), completion rates (CR), view quality, and patient acceptability. Secondary outcome measures: positive findings, diagnostic yield. RESULTS: No significant difference was noted among groups for GTT (median [minutes] M, CS, and CSM vs S: 17.3, 24.7, and 15.1 minutes vs 16.8 minutes, respectively; P = .62, .18, and .30, respectively), SBTT (median [minutes] M, CS, and CSM vs S: 260, 241, and 201 vs 278, respectively; P = .91, .81, and .32, respectively), or CRs (85%, 85%, and 88% vs 89% for M, CS, and CSM vs S, respectively; P = .74, .74, and 1.00, respectively). There was no significant difference in view quality among groups (of 44: 38, 37, and 40 vs 37 for M, CS, and CSM, vs S, respectively; P = .18, .62, and .12, respectively). Diagnostic yield was similar among the groups. CS and CSM regimens were significantly less convenient (P < .001), and CS was significantly less comfortable (P = .001) than standard preparation. CONCLUSIONS: Bowel purgatives and prokinetics do not improve CRs or view quality at CE, and bowel purgatives reduce patient acceptability. |
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Authors:
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Aymer Postgate; Paris Tekkis; Neil Patterson; Aine Fitzpatrick; Paul Bassett; Chris Fraser |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2009-01-18 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 69 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-04 Completed Date: 2009-08-06 Revised Date: 2010-09-03 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 1120-8 Citation Subset: IM |
Affiliation:
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Wolfson Unit for Endoscopy, St. Mark's Hospital, Imperial College London, UK. apostgate@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Capsule Endoscopy / methods* Cathartics / administration & dosage*, adverse effects Citric Acid / administration & dosage* Drug Administration Schedule Drug Combinations Drug Therapy, Combination Female Gastrointestinal Motility / drug effects* Gastrointestinal Transit / drug effects* Humans Intestinal Diseases / diagnosis* Intestine, Small* / drug effects Magnesium / administration & dosage*, adverse effects Male Metoclopramide / administration & dosage*, adverse effects Middle Aged Premedication Prospective Studies Senna Extract / administration & dosage*, adverse effects Simethicone / administration & dosage*, adverse effects Single-Blind Method Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Cathartics; 0/Drug Combinations; 364-62-5/Metoclopramide; 546-93-0/magnesium carbonate; 7439-95-4/Magnesium; 77-92-9/Citric Acid; 8013-11-4/Senna Extract; 8050-81-5/Simethicone |
| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2010 Sep;72(3):670-1; author reply 671
[PMID:
20801296
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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