Introduction That patients tolerate swallowing a capsule better than undergoing conventional colonoscopy (CC) is self evident, but without the ability to cleanse the bowel during the procedure capsule endoscopy is critically reliant on a clean bowel and preparation regimens tend to be more rigorous, which may affect the patients' acceptance of the procedure. In this study, patient tolerance of a standard regimen used for colon capsule endoscopy (CCE) was compared with that used for CC and a smaller volume regimen used for small bowel capsule endoscopy (SBCE) as a control.
Methods All patients undergoing CC, SBCE and CCE on the Clinical Investigation Unit were asked to score symptoms of nausea, vomiting, bloating, abdominal pain and headache as none, mild, moderate, severe or extreme and provide an overall tolerance score on a visual analogue scale (0: intolerable; 10: no symptoms). Laxatives administered were 4L (CC) and 2L (SBCE) Klean prep (Norgine Ltd., UK). 2L Klean prep was given the day before aswell as the day of CCE when two further “booster” doses of Fleet phospho-soda (Fleet Labs., Lynchburg, USA; 30 and 25 ml) were also administered. χ2 test was used to compare patients suffering none-mild and moderate-extreme symptoms with different regimens and one-tailed t test to compare overall tolerance.
Results 104 patients had bowel preparation for CC (n=28), SBCE (n=54) and CCE (n=22) and suffered moderate-extreme nausea (4, 21 and 18% respectively), vomiting (4, 8, 0%), bloating (21,17, 36%), abdominal pain (14, 25, 23%) and headache (11, 21, 32%). Moderate to extreme nausea was more common in those taking bowel preparation for SBCE than CC (p=0.04), but there were no differences in the distribution of any of the other symptoms between the different regimens. Overall tolerance score was (median (range)) 7.2 (1–9) with no difference between regimens. CCE and SBCE groups were similar in terms of sex (64 and 58% female respectively) and age (mean 39 and 49 years, p=0.1).
Conclusion Bowel preparation for endoscopic procedures is commonly associated with a wide range of symptoms. However patient tolerance of regimens used for CCE and CC were equivalent and indeed not demonstrably worse than the low volume preparation used for SBCE. This study suggests that the bowel preparation regimen is unlikely to influence patients' choice of CCE or CC as an investigative modality.
Competing interests None declared.
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