Adherence to the bowel cleansing regimen for pan-enteric capsule endoscopy in patients with suspected Crohn’s disease and factors affecting the image quality

Jacob Broder Brodersen, Karina Winther Andersen, Michael Dam Jensen*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objective: Pan-enteric capsule endoscopy (CE) is an attractive diagnostic approach in patients examined for Crohn’s disease (CD). The aim of this study was to examine the adherence to the recommended bowel cleansing regimen and determine clinical factors affecting the image quality. Methods: In a prospective blinded trial, patients with suspected CD were examined with the PillCam Crohn's capsule after bowel preparation with 2 + 2 L of polyethylene glycol (PEG) and sodium phosphate booster. The image quality was graded on a four-point scale. A good or excellent image quality defined a diagnostic procedure. Results: Fifty-nine patients participated. The mean volume of PEG was 2.5 L (CI 2.3–2.8). Ten patients (17%) were able to drink all 4 L of PEG, and 44 patients (75%) ingested ≥2 L. The image quality was poor, fair, good or excellent in 0%, 29.3%, 29.3% and 41.4%, respectively. The mean volume of PEG was 1.9 L (CI 1.4–2.4), 2.2 L (CI 1.8–2.7) and 3.2 L (CI 2.8–3.5) in patients with a fair, good or excellent image quality (p <.001). In a regression analysis, only the volume of PEG was associated with the obtained image quality (r s=0.52; p <.001). The diagnostic yield was equal in patients with a diagnostic or non-diagnostic procedure (43.9% and 47.1%, respectively). Conclusions: In patients examined with pan-enteric CE for suspected CD, the volume of PEG is the major factor affecting the image quality. Although few patients are able to ingest the recommended volume, the diagnostic yield is not affected.

Original languageEnglish
JournalScandinavian Journal of Gastroenterology
Volume57
Issue number4
Pages (from-to)501-506
ISSN0036-5521
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • bowel cleansing
  • capsule endoscopy
  • Crohn’s disease

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