Bowel preparation for small bowel capsule endoscopy in patients with suspected or established Crohn’s disease

BACKGROUND: Although small-bowel capsule endoscopy (SBCE) is an important tool in the diagnosis of Crohn's disease (CD), the necessity and consensus protocol of preprocedural bowel pre-treatment for SBCE in patients with CD have not yet been established. AIM: To evaluate the diagnostic performance and mucosal visibility of SBCE with and without bowel preparation in patients with CD. METHODS: Patients with suspected or established CD who underwent SBCE at our hospital between January 2015 and March 2025 were included in this retrospective observational study. SBCE was performed after bowel preparation with fasting only or with 1 L of polyethylene glycol solution with liquid simethicone. The primary outcome was the lesion detection rate. Secondary outcomes were the completion rate of the examination, image quality, gastric transit time, small bowel transit time, and adverse events related to SBCE. RESULTS: Fifty-seven patients were included in the study. The detection rates of lesions were 95.6% in the non-preparation group and 96.6% in the preparation group, with no significant differences between the two groups. The two groups showed no significant differences in completion rates, gastric transit time, small bowel transit time, or visibility score. One patient in the preparation group experienced intestinal obstruction. CONCLUSION: The diagnostic performance and mucosal visibility of SBCE for CD were not significantly improved by pre-procedural bowel preparation.