Gut Liver.  2025 Jan;19(1):87-94. 10.5009/gnl240216.

Comparing 1-L and 2-L Polyethylene Glycol with Ascorbic Acid for Small Bowel Capsule Endoscopy: A Randomized Controlled Trial

• Oh CK
• Lee SP
• Lee JG
• Yang YJ
• Seo SI
• Bang CS
• Kim YJ
• Shin WG
• Kim JB
• Jang HJ
• Kae SH
• Baik GH
• HGSG

• KMID: 2564737
• DOI: http://doi.org/10.5009/gnl240216

Abstract

Background/Aims
Small bowel capsule endoscopy (SBCE) has become the standard for initial evaluation in the diagnosis of small bowel lesions. Although optimal visualization of the mucosa is important, patients experience difficulty in consuming a large volume of bowel preparation agents. This study aimed to compare the efficacy and safety of 1-L polyethylene glycol (PEG) with ascorbic acid (AA) and 2-L PEG with AA.
Methods
In this prospective, multicenter, non-inferiority study, patients who received SBCE were randomly assigned to consume 1-L PEG with AA or 2-L PEG with AA for small bowel preparation. The primary outcome was adequate small bowel visibility quality (SBVQ). The secondary outcomes included diagnostic yield, cecal complete rate, and adverse events.
Results
One hundred and forty patients were enrolled in this study, 70 patients per group. In the per-protocol analysis, there were no significant differences in the adequate SBVQ rate (94.0% vs 94.3%; risk difference, –0.3; 95% confidence interval, –8.1 to 7.6; p=1.000), diagnostic yield rate (49.3% vs 48.6%, p=0.936), or cecal complete rate (88.1% vs 92.9%, p=0.338) between the 1-L PEG with AA group and 2-L PEG with AA group. The incidence of adverse events did not differ significantly between the groups (12.9% vs 11.9%, p=0.871).
Conclusions
One liter-PEG with AA is not inferior to 2-L PEG with AA in terms of adequate SBVQ for SBCE. One liter-PEG with AA can be recommended as the standard method for bowel cleansing for SBCE.

Keyword

Capsule endoscopes; Video capsule endoscopes; Bowel preparation solutions; Polyethylene glycols