Small bowel cleansing for capsule endoscopy in paediatric patients: A prospective randomized single-blind study

Background: Small bowel cleansing by capsule endoscopy has never been addressed in children. Methods: Randomized controlled trial to evaluate the effect of five bowel preparation regimens on the mucosal visibility surface (as percentage of visualized surface area). Group A: a clear liquid diet for 12 h on the day before; Group B: high volume polyethylene glycol (50 mL/kg, up to 2 Lt/die); Group C: low volume polyethylene glycol (25 mL/kgupto 1 Lt/die); Group D: 20 mL(376 mg) of oral simethicone; Group E: 25 mL/kg (up to 1 Lt/die) of polyethylene glycol solution plus 20mL (376 mg) of oral simethicone. Results: Overall, 198 patients (53% male, median age 13 years) were enrolled. Preparation regimen visualization scores were 14.1 +/- 4.2, 18.9 +/- 5.1, 17.8 +/- 5.5, 14.9 +/- 4.8 and 20.9 +/- 4.6 in groups A, B, C, D and E, respectively (P < 0.01). Positive findings were found in 172 cases (87%), but no significant differences were observed in the diagnostic yield and tolerability. Interobserver agreement, k = 0.89 (95% CI 0.83 +/- 0.71). Conclusion: This is the first report in children that supports the use of 25 mL/kg (up to 1 Lt/die) of polyethylene glycol solution plus 20mL (376 mg) of oral simethicone as the preparation of choice for capsule endoscopy. (C) 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.