Purgative Small Bowel Preparation for Capsule Endoscopy? Maybe, but Think Out of the Box!

  • Paraskevas Gkolfakis
  • Georgios Tziatzios
  • Konstantinos TriantafyllouEmail author

Dear Editor,

American [1] and European Society of Gastrointestinal Endoscopy [2]—either empirically or based on data about mucosa visualization—advocate the use of 2L of PEG prior to small bowel video capsule endoscopy (VCE), contrary to the device manufacturers’ recommendations. In their review, Cave et al. [3] recommend against the use of purgatives prior to VCE due to lack of adequate data. However, this particular authors’ argument is indeed well supported by the results of the most recently published meta-analysis on this matter [4]. Analysis of data from 12 randomized controlled trials with more than 1220 examinations challenges the usefulness of purgative preparation before small bowel VCE since it increases neither examination’s diagnostic yield [risk ratio 1.17 (0.97–1.40)] nor small bowel mucosa visualization [0.99 (0.95–1.04)] [4].

Agreeing with the authors that preparation before VCE remains an open discussion and that further studies with standardized definitions,...


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens“Attikon” University General HospitalAthensGreece
  2. 2.Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University HospitalUniversité Libre de BruxellesBrusselsBelgium
  3. 3.Department of GastroenterologyUniversity Hospital AugsburgAugsburgGermany

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