ABSTRACT
BACKGROUND AND OBJECTIVE: There is no consensus concerning small bowel preparation before capsule endoscopy (CE). This study evaluated the effects of 4 regimens on small bowel cleansing and diagnostic yield. METHODS: Patients were randomly divided into 4 groups. Group A consumed a clear liquid diet after lunch on the day before CE, followed by overnight fasting. Group B took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In group C, the same regimen was taken at 20:00 hours on the day before and at 05:00 hours on the day of CE. In group D, in addition to the group C regimen, 20 mL oral simethicone was taken 30 minutes before CE. RESULTS: Two hundred patients were prospectively enrolled, and 7 were excluded from the final analysis because of incomplete small bowel transit. No significant difference was noted among the 4 groups for small bowel transit time. Bowel preparation in group D was significantly better than for the other regimens for overall cleansing of the proximal small bowel, and showed improved overall cleansing of the distal small bowel when compared with 10-hours overnight fasting. Pathological lesions of the proximal and distal small bowel were, respectively, achieved in 82 and 74 patients, mostly distributed in group D. CONCLUSIONS: Small bowel preparation that involves split-dose oral mannitol plus single-dose simethicone for CE can improve mucosal visualization and subsequent diagnostic yield when compared with 10-hours overnight fasting.
Subject(s)
Antifoaming Agents/therapeutic use , Capsule Endoscopy/methods , Diuretics, Osmotic/therapeutic use , Intestine, Small/drug effects , Mannitol/therapeutic use , Premedication , Simethicone/therapeutic use , Administration, Oral , Adolescent , Adult , Aged , Aged, 80 and over , Antifoaming Agents/administration & dosage , Diuretics, Osmotic/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Gastrointestinal Transit/drug effects , Humans , Male , Mannitol/administration & dosage , Middle Aged , Prospective Studies , Simethicone/administration & dosage , Therapeutic Irrigation/methods , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Constipation is a common clinical symptom but its etiology remains unknown. The aims of the study are to discuss the relation between body mass index (BMI), motilin and the slow transit constipation (STC). METHODS: A total of 178 patients with STC and 123 healthy volunteers as controls were divided into three groups according to the BMI, group A (BMI <20), group B (BMI 20-25), and group C (BMI > 25). Fasting and one hour postprandial plasma motilin were measured and the results were analyzed. RESULTS: There was significant difference in the constituent ratio between STC patients and healthy controls (p < 0.05). The percentage of group A, B and C in STC patients was 49.4% (88/178), 23.0% (41/178) and 27.6% (49/178), respectively; and group A had a higher percentage. Plasma motilin of fasting and one hour postprandial in STC patients of group A was significantly lower than that of group B and C (p < 0.05), but there was no difference between group B and C (p > 0.05). There was no significant difference in the results of plasma motilin of fasting and one hour postprandial among the three groups of healthy controls (p > 0.05). Plasma motilin of fasting and one hour postprandial in STC patients of group A was significantly lower than those healthy controls of group A (p < 0.05). The same results of plasma motilin of fasting and one hour postprandial could be seen in group B and C, respectively (p < 0.05). CONCLUSIONS: A higher proportion of low BMI sufferers was found in the STC patients. The reason may be related to the lower release of the plasma motilin.
