Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis(UC).Imaging can be used non-invasively to determine the extent of involvement,severity of disease and to detect disease-r...Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis(UC).Imaging can be used non-invasively to determine the extent of involvement,severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease(IBD)manifestations.While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings,the use of computed tomography enterography(CTE)or magnetic resonance enterography(MRE)are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation.Additionally,CT colonography and MR colonography are emerging techniques with potential applications in UC.Ultrasonography,leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations.This plethora of radiological imaging options has become a vital component of UC assessments.展开更多
Background:Capsule endoscopy(CE)is frequently hindered by intra-luminal debris.Our aim was to determine whether a combination bowel preparation would improve small-bowel visualization,diagnostic yield,and the completi...Background:Capsule endoscopy(CE)is frequently hindered by intra-luminal debris.Our aim was to determine whether a combination bowel preparation would improve small-bowel visualization,diagnostic yield,and the completion rate of CE.Methods:Single-blind,prospective randomized–controlled study of outpatients scheduled for CE.Bowel-preparation subjects ingested 2 L of polyethylene glycol solution the night prior to CE,5mL simethicone and 5mg metoclopramide 20 minutes prior to CE and laid in the right lateral position 30 minutes after swallowing CE.Controls had no solid food after 7 p.m.the night prior to CE and no liquids 4 hours prior to CE.Participants completed a satisfaction survey.Capsule readers completed a small-bowel-visualization assessment.Results:Fifty patients were prospectively enrolled(56%female)with a median age of 54.4 years and 44 completed the study(23 patients in the control group and 21 in the preparation group).There was no significant difference between groups on quartile-based small-bowel visualization(all P>0.05).There was no significant difference between groups in diagnostic yield(P=0.69),mean gastric(P=0.10)or small-bowel transit time(P=0.89).The small-bowel completion rate was significantly higher in the preparation group(100%vs 78%;P=0.02).Bowel-preparation subjects reported significantly more discomfort than controls(62%vs 17%;P=0.01).Conclusions:Combined bowel preparation did not improve small-bowel visualization but did significantly increase patient discomfort.The CE completion rate improved in the preparation group but the diagnostic yield was unaffected.Based on our findings,a bowel preparation prior to CE does not appear to improve CE performance and results in decreased patient satisfaction(ClinicalTrials.gov,No.NCT01243736).展开更多
文摘Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis(UC).Imaging can be used non-invasively to determine the extent of involvement,severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease(IBD)manifestations.While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings,the use of computed tomography enterography(CTE)or magnetic resonance enterography(MRE)are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation.Additionally,CT colonography and MR colonography are emerging techniques with potential applications in UC.Ultrasonography,leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations.This plethora of radiological imaging options has become a vital component of UC assessments.
文摘Background:Capsule endoscopy(CE)is frequently hindered by intra-luminal debris.Our aim was to determine whether a combination bowel preparation would improve small-bowel visualization,diagnostic yield,and the completion rate of CE.Methods:Single-blind,prospective randomized–controlled study of outpatients scheduled for CE.Bowel-preparation subjects ingested 2 L of polyethylene glycol solution the night prior to CE,5mL simethicone and 5mg metoclopramide 20 minutes prior to CE and laid in the right lateral position 30 minutes after swallowing CE.Controls had no solid food after 7 p.m.the night prior to CE and no liquids 4 hours prior to CE.Participants completed a satisfaction survey.Capsule readers completed a small-bowel-visualization assessment.Results:Fifty patients were prospectively enrolled(56%female)with a median age of 54.4 years and 44 completed the study(23 patients in the control group and 21 in the preparation group).There was no significant difference between groups on quartile-based small-bowel visualization(all P>0.05).There was no significant difference between groups in diagnostic yield(P=0.69),mean gastric(P=0.10)or small-bowel transit time(P=0.89).The small-bowel completion rate was significantly higher in the preparation group(100%vs 78%;P=0.02).Bowel-preparation subjects reported significantly more discomfort than controls(62%vs 17%;P=0.01).Conclusions:Combined bowel preparation did not improve small-bowel visualization but did significantly increase patient discomfort.The CE completion rate improved in the preparation group but the diagnostic yield was unaffected.Based on our findings,a bowel preparation prior to CE does not appear to improve CE performance and results in decreased patient satisfaction(ClinicalTrials.gov,No.NCT01243736).
