Superiority of the Split-dose PEG Regimen for Small-Bowel Capsule Endoscopy: A Randomized Controlled Trial : Journal of Clinical Gastroenterology

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ONLINE ARTICLE: Original Article

Superiority of the Split-dose PEG Regimen for Small-Bowel Capsule Endoscopy

A Randomized Controlled Trial

Magalhães-Costa, Pedro MD; Carmo, Joana MD; Bispo, Miguel MD; Santos, Sofia MD; Chagas, Cristina MD

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Journal of Clinical Gastroenterology 50(7):p e65-e70, August 2016. | DOI: 10.1097/MCG.0000000000000460



We aimed to evaluate the small-bowel cleansing quality, the diagnostic yield (DY), the transit time, and the patients’ tolerability, by comparing the 2 different polyethylene glycol (PEG) administration schedules.


The use of bowel purgatives before small-bowel capsule endoscopy (SBCE) is recommended by the ESGE guidelines. Whether this regimen can be further refined by changing the timing of administration is unknown.


Fifty-seven patients were prospectively enrolled and randomized into 2 groups: group 1 (G1, n=29) received 2 L of PEG in the day before SBCE (time between PEG and SBCE=10 h); and group 2 (G2, n=28) received 1 L of PEG in the day before SBCE and 1 L of PEG in the morning before SBCE (time between PEG and SBCE=4 h). The primary outcome measure was small-bowel cleansing quality. Small-bowel cleansing quality was evaluated according to a previously validated grading scale.


The entire and distal half small-bowel cleansing scores were significantly higher among G2 (median score: 8 vs. 10 points, P=0.012; median score: 6 vs. 8 points, P=0.05, respectively). The DY did not differ significantly between groups. There were no significant differences in transit times between the 2 PEG regimens. Both schedules were well tolerated, showing no differences regarding symptoms while ingesting the preparation or after SBCE ingestion.


Split-dose PEG regimen for SBCE preparation improved the small-bowel cleanliness, did not interfere with transit times and was equally well tolerated by the patients. No differences were observed regarding DY. registration: NCT02396017.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

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