Kapselendoskopie: Vorbereitung und Prokinetika

Zusammenfassung

Durch die Einführung der Kapselendoskopie wurde die Untersuchung des Dünndarms revolutioniert, insbesondere die Diagnostik einer mittleren gastrointestinalen Blutung. Die Diagnostik mittels der Kapselendoskopie kann jedoch eingeschränkt sein durch das Vorhandensein von Stuhlresten oder Luftblasen. Im Gegensatz zur Hersteller­empfehlung verbessert die Vorbereitung mittels Darmlavage die Sicht auf die Mukosa und erhöht hierdurch die diagnostische Ausbeute. Ein weiteres Problem ist die inkomplette Untersuchung des Dünndarms durch eine verzögerte Magen- und / oder Dünndarmtransitzeit. In mehreren Studien konnte kein eindeutiger Vorteil für den zusätzlichen Einsatz eines Prokinetikums gezeigt werden.

Abstract

The introduction of video capsule endoscopy has revolutionized the diagnosis of small bowel dis­eases, particulary the analysis of obscure gastrointestinal bleeding. Although capsule endoscopy has been shown to be superior to alternative techniques for diagnosis small bowel lesions, its diagnostic yield can be limited by the presence of dark or opaque fluid or air bubbles, which can hamper or prevent diagnosis by causing incomplete visualization of the intestinal mucosa. Current evidence indicates that bowel preparation with purgative agents increases the diagnostic yield of the procedure by improving small bowel mucosal visu­alization compared with a clear liquid diet or overnight fast. Furthermore, slow gastric emptying or small bowel transit can prevent the capsule from reaching the ileo-cecal valve within the battery life of approximately 8 hours. At this time, it is unclear, if procinetic drugs could improve the proportion of cases in which the colon is reached during the recording time.

Schlüsselwörter

Kapselendoskopie - Vorbereitung - Prokinetika - Dünndarm

Key words

capsule endoscopy - preparation - procinetic drugs - small bowel

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