Song Hyun Joo
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Korean J Gastroenterol. 2020 Feb 25;75(2):74-78. doi: 10.4166/kjg.2020.75.2.74.
For improved examination of video capsule endoscopy (VCE) and device-assisted enteroscopy (DAE), bowel preparation is an essential issue. Multiple factors like air bubbles, food material in the small bowel, and gastric and small bowel transit time affect the small bowel visualization quality (SBVQ), diagnostic yield (DY) and cecal completion rate (CR). Bowel preparation with polyethylene glycol (PEG) solution enhances SBVQ and DY, but it has no effect on CR. Bowel preparation with PEG solution 2 L is similar to PEG 4 L in SBVQ, DY, and CR. Bowel preparation with fasting or PEG solution combined with anti-foaming agents like simethicone enhance SBVQ, but it has no effect on CR. Bowel preparation with prokinetics is not commonly recommended. Optimal timing for purgative bowel preparation has yet to be established. However, the studies regarding bowel preparation for DAE are not sufficient. European Society of Gastrointestinal Endoscopy (ESGE) recommends 8-12 hours fasting from solid food and 4-6 hours fasting from liquids prior to the antegrade DAE. For retrograde DAE, colonoscopy preparation regimen is recommended. This article reviews the literature and ESGE, 2013 Korean published guidelines regarding bowel preparation for VCE and DAE, following suggestion for optimal bowel preparation for VCE and balloon enteroscopy.
为了更好地进行视频胶囊内镜检查(VCE)和器械辅助小肠镜检查(DAE),肠道准备是一个至关重要的问题。气泡、小肠内的食物残渣以及胃和小肠的转运时间等多种因素会影响小肠可视化质量(SBVQ)、诊断率(DY)和盲肠完成率(CR)。用聚乙二醇(PEG)溶液进行肠道准备可提高SBVQ和DY,但对CR没有影响。使用2L PEG溶液进行肠道准备在SBVQ、DY和CR方面与4L PEG相似。禁食或使用PEG溶液并联合西甲硅油等消泡剂进行肠道准备可提高SBVQ,但对CR没有影响。通常不推荐使用促动力药进行肠道准备。清肠性肠道准备的最佳时机尚未确定。然而,关于DAE肠道准备的研究并不充分。欧洲胃肠内镜学会(ESGE)建议在顺行DAE前禁食固体食物8 - 12小时,禁食液体4 - 6小时。对于逆行DAE,建议采用结肠镜检查的准备方案。本文回顾了相关文献以及ESGE 2013年韩国发表的关于VCE和DAE肠道准备的指南,并对VCE和气囊小肠镜检查的最佳肠道准备提出了建议。