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Exploring Panendoscopy With a Colon Capsule: Issues of Bowel Preparation, Transit, Completion, Acceptance

Douglas K. Rex, MD, MASGE reviewing Vuik FER, et al. Endosc Int Open 2021 Dec.

This study looked at issues of technical success and acceptance of panendoscopy with a colon capsule in 451 generally healthy adults aged 50 to 75 years. Patients received 5 mg of bisacodyl, 2 L of Moviprep (Norgine, Amsterdam, the Netherlands), and 2 L of water in a split dose. They also received a booster of 10 mg of metoclopramide and 0.5 L of oral sulfate solution, given as 0.25 L immediately after small bowel recognition and 0.25 L 3 hours later. 

Cleansing of the entire GI tract was adequate in 52.8% of participants, but visualization was good for the stomach in 70% of patients and for the small bowel in 99.1%. For the colon, visualization was good or excellent in 77%, with insignificant bubbles in 75%.

The completion rate of the colon capsule was 51.9%, with 94.7% reaching the descending colon and 55.4% the rectum. The esophageal Z line was seen well in 44.8%. 

Patients graded the experience at 7.8 on a scale of 1 to 10. Overall, 91% would consider a repeat colon capsule endoscopy, and only 6.6% would advise against it. The most burdensome part was bowel preparation, according to 89.2% of the patients.


Comment:

It’s hard to imagine a clinical scenario for either screening or diagnosis in which capsule endoscopy in its current form would get significant use. Perhaps some asymptomatic, well persons would be attracted to the concept of noninvasive panendoscopic screening.

https://www.asge.org/images/default-source/journal-scan/drrex-2021-cropped-headshot.jpg?sfvrsn=2268e45d_2

Douglas K. Rex, MD, MASGE

Bio and Disclosures

Citation(s):

Vuik FER, Moen S, Nieuwenburg SAV, Schreuders EH, Kuipers EJ, Spaander MCW. Applicability of colon capsule endoscopy as pan-endoscopy: from bowel preparation, transit, and rating times to completion rate and patient acceptance. Endosc Int Open 2021;9:E1852-E1859. (https://doi.org/10.1055/a-1578-1800)
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