Simethicone for small bowel preparation for capsule endoscopy:: A systematic, single-blinded, controlled study

Background: Capsule endoscopy is a new imaging method for visualization of the entire small bowel. However, no standardized protocol for bowel preparation for capsule endoscopy has been evaluated. Methods: Capsule endoscopy was performed in 36 consecutive patients, all of whom fasted for 12 hours before ingestion of the capsule. Before capsule endoscopy, 18 patients received 80 mg simethicone and 18 had no supplemental medication for bowel preparation. Two observers, both experienced endoscopists, independently reviewed the examinations in a single-blinded and randomly assigned fashion. Mucosal visibility and intraluminal gas bubbles were assessed and graded by both observers. Results: Bowel preparation with simethicone resulted in significantly better visibility because of fewer intraluminal bubbles (p<0.01). Interobserver agreement was excellent (r greater than or equal to 0.8; k 0.78: 95% CI[0.57, 0.98]). No adverse effect of simethicone was observed. Conclusions: Simethicone may be added to the routine preparation for capsule endoscopy to improve the visibility of small bowel mucosa.