Research Article of Open Journal of Gastroenterology and Hepatology
A pilot study for using high-volume colon irrigation bowel preparation for colon capsule endoscopy shows feasibility of adequate bowel prep with high patient satisfaction
David J. Hass MD FACG1*, William Stassen MD2, Dawn B. Burleson RN MBA CRA3, Gavriel D. Meron MBA3, Orly Levitan PhD3, David A. Johnson MD MACG FASGE MACP4
1Yale University, Hamden, CT, USA; 2Austin Gastroenterology, Austin, TX, USA; 3Hygieacare Inc., Norfolk, VA, USA; 4Eastern VA Medical School, Norfolk, VA, USA.
A feasibility study was performed to test a bowel preparation (BP) method that would improve patients’ experience of colon capsule endoscope (CCE) while retaining clinical adequacy. Specifically, the use of high-volume colon irrigation with the Hygieacare® System, HygiPrep™, was tested in conjunction with Medtronic’s PillCam COLON 2 Capsule. This prospective, single-center, and IRB-approved study evaluated HygiPrep use prior to the PillCam COLON 2 procedure instead of the standard split-polyethylene glycol-electrolyte (PEG) oral prep. The study was performed at Austin Gastroenterology (Austin, TX), and all capsule video files were forwarded to a Central Reader to evaluate and compile a study report. Six of the seven (86%) subjects completed both the HygiPrep and PillCam COLON 2 exams and were graded as excellent, good, or adequate by the Central Reader. Patients’ feedback reported positive satisfaction scores for both the HygiPrep and the PillCam COLON 2 procedures. These results support our hypothesis that HygiPrep was as effective as Split-PEG BP. We suggest that the HygiPrep, is a suitable BP for CCE, providing adequate BP and high patient satisfaction.
Keywords: Capsule Endoscopy; Colon Capsule Endoscopy; Colon Preparation; Colonoscopy Quality; HygiPrep; PillCam; COLON 2
How to cite this article:
David J. Hass, William Stassen, Dawn B. Burleson Gavriel D.Meron, Orly Levitan, David A. Johnson MD MACG FASGE MACP.A pilot study for using high-volume colon irrigation bowel preparation for colon capsule endoscopy shows feasibility of adequate bowel prep with high patient satisfaction. Open Journal of Gastroenterology and Hepatology, 2021; 4:49. DOI: 10.28933/ojgh-2021-03-1005
1. Hong SN, Kang S-H, Jang HJ, Wallace MB. Recent Advance in Colon Capsule Endoscopy: What’s New? Clin Endosc. 2018;51(4):334-343. doi:10.5946/ce.2018.121
2. Sieg A. Capsule endoscopy compared with conventional colonoscopy for detection of colorectal neoplasms. World J Gastrointest Endosc. 2011;3(5):81-85. doi:10.4253/wjge. v3.i5.81
3. Underwood JA, Bekal P, Levitan O, Burleson DB, Johnson DA. Hygieacare prep for colonoscopy consistently provides 97% adequacy, and is agnostic to predictors of poor oral bowel prep. Gastrointest Endosc. 2020;91(6):AB573-AB574. doi:10. 1016/j.gie.2020.03.3336
4. Gagneja HK, Parekh P, Burleson DB, Johnson D. Patient satisfaction and willingness to pay out of pocket for future hygieacare preps: 2403. Off J Am Coll Gastroenterol ACG. 2016; 111:S1236.
5. Sportes A, Delvaux M, Huppertz J, Hernandez C, Gay G. Randomized trial comparing high volume rectal water irrigation with standard 4 l split-dose PEG preparation before colonoscopy. J Gastroenterol Dig Dis. 2016;1(1).
6. Das A, Parekh PJ, Bekal P, et al. Bowel preparation for colonoscopy: a comparative cost-effective analysis of traditional per os purgatory prep versus a novel method using high-volume colonic water irrigation. ARC J Hepatol Gastroenterol. 2017;2(2):23-31.
7. Parekh P, Oldfield E, Johnson D. Bowel preparation for colonoscopy. in: clinical gastrointestinal endoscopy. Third. Elsevier; 2018.https://www.elsevier.com/books/clinical-gastrointestinal-endoscopy/chandrasekhara/978-0-323-41509-5
8. Spada C, Hassan C, Munoz-Navas M, et al. Second-generation colon capsule endoscopy compared with colonoscopy. Gastrointest Endosc. 2011;74(3):581-589.e1. doi:10.1016/j.gie. 2011.03.1125
9. Rondonotti E, Borghi C, Mandelli G, et al. Accuracy of capsule colonoscopy and computed tomographic colonography in individuals with positive results from the fecal occult blood test. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2014;12(8):1303-1310. doi:10.1016/j.cgh.2013.12.027
10. Rex DK, Adler SN, Aisenberg J, et al. Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastro-enterology. 2015;148(5):948-957.e2. doi:10.105 3/j. gas tro.2015.01.025
11. D’Haens G, Löwenberg M, Samaan MA, et al. Safety and feasibility of using the second-generation pillcam colon capsule to assess active colonic crohn’s disease. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2015;13(8):1480-1486.e3. doi:10.1016/j.cgh.2015.01.031
12. Spada C, De Vincentis F, Cesaro P, et al. Accuracy and safety of second-generation PillCam COLON capsule for colorectal polyp detection. Ther Adv Gastroenterol. 2012;5(3):173-178. doi:10.1177/1756283X12438054
13. Goran L, Negreanu AM, Stemate A, Negreanu L. Capsule endoscopy: Current status and role in Crohn’s disease. World J Gastrointest Endosc. 2018;10(9):184-192. doi:10.4253/wjge.v10.i9.184
14. Spada C, Hassan C, Galmiche JP, et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2012;44(5):527-536. doi:10.1055/s-0031-1291717
15. Rex DK, Boland CR, Dominitz JA, et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112(7):1016-1030. doi:10. 1038/ajg.2017.174
16. Singhal S, Nigar S, Paleti V, Lane D, Duddempudi S. Bowel preparation regimens for colon capsule endoscopy: a review. Ther Adv Gastroenterol. 2014;7(3):115-122. doi:10.1 177/17 56283X13504730
17. Johnson DA, Barkun AN, Cohen LB, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology. 2014;147(4):903-924. doi:10 .1053/j.gastro.2014.07.002
18. Milluzzo SM, Bizzotto A, Cesaro P, Spada C. Colon capsule endoscopy and its effectiveness in the diagnosis and management of colorectal neoplastic lesions. Expert Rev Anticancer Ther. 2019;19(1):71-80. doi:10.1080/14737140.2019.1538798
19. Negreanu L, Smarandache G, Mateescu RB. Role of capsule endoscopy Pillcam COLON 2 in patients with known or suspected Crohn’s disease who refused colonoscopy or underwent incomplete colonoscopic exam: a case series. Tech Coloproctology. 2014;18(3):277-283. doi: 10.1007/s10151-013-1054-3
20. Thygesen MK, Baatrup G, Petersen C, Qvist N, Kroijer R, Kobaek-Larsen M. Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study. Acta Oncol. 2019;58(sup1):S71-S76. doi:10.1080/02 84186X.2019.1581372