INTESTINAL PREPARATION FOR CAPSULE ENDOSCOPY, DOES IT IMPROVE WITH SIMETHICONE?

Aims To evaluate if simethicone improves the intestinal preparation for capsule endoscopy.

Methods A retrospective descriptive study. Review of 30 procedures. In 15 the preparation was only 8-hour fast. In another 15 the patients also received 100mg of oral simethicone. Solid intake is restarted after 4 hours. The preparation is categorized as adequate or inadequate according to the adequacy assessment of Brotz.

Results Of the 15 patients in whom the preparation was only fasting, in seven (47%) it was inadequate due to detritus and sparkling content. In the five patients taking oral iron, the cleansing was adequate.

Of the 15 that received simethicone, in nine (60%) the preparation was inadequate due to detritus, but foam was not objectified in any. Of these nine patients, one did not respect 4-hour fast after capsule ingestion and another had gastroparesis. Six patients were taking iron, and only two (33%) had adequate cleansing.

Conclusions

1. There are no standardized scales that assess the adequacy of bowel cleansing, so its evaluation is based on subjective judgments.

2. Simethicone has a positive impact on the small bowel cleansing and decreases the presence of bubbles and foam, as subjectively described in our series.

3. Despite the simethicone, 60% of patients have subjectively inadequate preparation. Stopping treatment with iron, optimizing the diet the previous day and longer fasting after capsule ingestion (7 hours for solids) could improve it.

4. Further studies are needed to assess the indication of purgatives, the doses, and the time for their intake.

Publication History

Article published online:
14 April 2022