Bowel preparation before small bowel capsule endoscopy: what is the optimal approach?

Koornstra et al
European Journal of Gastroenterology & Hepatology October 2009 - Volume 21 - Issue 10

Special Author Introduction 
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Capsule endoscopy has revolutionized the diagnosis of suspected small bowel diseases, particularly the investigation of obscure gastrointestinal bleeding. The procedure is safe, minimally invasive and generally well-tolerated. However, the diagnostic yield of the procedure is dependent upon the level of visibility of the intestinal mucosa. Therefore, adequate bowel cleansing is of critical importance for the procedure. Thus, there is a rationale to perform some form of small bowel preparation before small bowel capsule endoscopy.

Although several studies have been performed on different types of bowel preparation prior to capsule endoscopy, there is currently no consensus about the optimal strategy. In the European Journal of Gastroenterology and Hepatology, an overview was recently given of current preparation strategies [1]. Taken together, current evidence indicates that bowel preparation before small bowel capsule endoscopy is mandatory. A preparation regimen using 2 litres of PEG solution appears to be sufficient and can therefore be recommended.