Published online Jul 5, 2021. doi: 10.4292/wjgpt.v12.i4.79
Peer-review started: February 2, 2021
First decision: February 24, 2021
Revised: March 22, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 5, 2021
Colon capsule endoscopy (CCE) is a usefulness imaging modality because it can be performed non-invasively. However, there is one major limitation of CCE, as bowel preparations for CCE require a larger volume of laxative than that used in conventional colonoscopy because of the need for capsule excretion completion. Therefore, the development of a new bowel preparation method with comparable liquid volume to colonoscopy is necessary to increase patients’ CCE tolerability.
Castor oil could have the potential to accelerate the capsule excretion through the colon and reduce the volume of the liquid laxative.
In this study, we attempted to clarify the effectiveness and tolerability of our modified regimen, which uses castor oil as a booster.
Twenty patients suspected of colorectal diseases were enrolled in this prospective cohort study. We used modified CCE regimen using castor oil as a booster. The capsule excretion rate within the battery life, bowel cleansing level in different segments of the colorectum, and detection rates of colorectal lesions were evaluated. In this study, we asked the patients to complete a questionnaire to assess the CCE tolerability.
Seventeen patients (85%) successfully followed our castor oil–based regimen, whereas three patients (15%) were unable to ingest castor oil because of its taste and failed to expel the capsule within the duration of battery life. The mean large bowel transit time was 236 min. The percentage of patients with satisfactory colon cleansing levels was 70%. The sensitivity, specificity, and diagnostic accuracy rates in detecting colorectal polyps with a size ≥ 6 mm were 76.9%, 75.0%, and 76.4%, respectively. Twelve patients (71%) evaluated the CCE procedure as more than “good” in the questionnaire, thus confirming the tolerability of our new regimen.
This study shows the safety and utility of modified bowel preparation for CCE, which uses castor oil, and found that that it can achieve capsule excretion, colon cleansing, high tolerability of CCE preparation, and reduction of liquid laxative volume.
A prospective multicenter trial is required to assess the safety and utility of castor oil–boosted bowel preparation for CCE.