Gastrointestinal Hemorrhage Clinical Trial
Official title:
A Randomised Study of the Optimal Bowel Preparation for Routine Capsule Endoscopy Using Citramag and Senna or Metoclopramide
The aim of this study is to determine whether taking bowel preparation (citramag and senna)
or a medicine to speed up transit through the stomach (metoclopramide), will improve the
quality of the images seen, increase the transit through the small bowel, and increase the
rate of completion of capsule endoscopy.
The secondary objective is to determine whether patients could routinely tolerate this bowel
preparation prior to capsule endoscopy and whether the diagnostic yield of capsule endoscopy
is improved.
Capsule endoscopy is a diagnostic tool for the detection of small bowel disease allowing
noninvasive endoscopic examination of the entire small bowel without the need for sedation.
Its limited battery life of 8+/-1 hours means it is paramount that the Capsule reaches the
caecum, visualizing the whole of the small intestine, and also that the mucosal views
obtained are clear, facilitating detection of pathologic lesions.
So far no optimal protocol for bowel preparation prior to Capsule endoscopy has been
established. Recently, several studies have shown that bowel preparation with polyethylene
glycol significantly reduces both gastric and small bowel transit times. Similarly,
visualization of the small intestine and therefore 'diagnostic yield' have both been shown
to be improved by both sodium phosphate and polyethylene glycol preparation. A more recent
study by Selby et al also demonstrates that the prokinetic agent metoclopramide (which is
known to promote emptying of the stomach) reduced both stomach and small bowel transit time,
increasing completion rates from 76% to 97%).
The proposal is to perform a randomised, controlled study using Citramag and Senna bowel
preparation or Metoclopramide to determine whether test completion rates are improved and
whether the images of the bowel are of better quality.
The hypothesis is that the improved wall visibility and increased completion rates will
improve the diagnostic yield of Capsule endoscopy and therefore improve patient care.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Diagnostic
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