Capsule Endoscopy: Preparation and Procinetics

The introduction of video capsule endoscopy has revolutionized the diagnosis of small bowel diseases, particulary the analysis of obscure gastrointestinal bleeding. Although capsule endoscopy has been shown to be superior to alternative techniques for diagnosis small bowel lesions, its diagnostic yield can be limited by the presence of dark or opaque fluid or air bubbles, which can hamper or prevent diagnosis by causing incomplete visualization of the intestinal mucosa. Current evidence indicates that bowel preparation with purgative agents increases the diagnostic yield of the procedure by improving small bowel mucosal visualization compared with a clear liquid diet or overnight fast. Furthermore, slow gastric emptying or small bowel transit can prevent the capsule from reaching the ileo-cecal valve within the battery life of approximately 8 hours. At this time, it is unclear, if procinetic drugs could improve the proportion of cases in which the colon is reached during the recording time.