Improving Bowel Preparation for the Colon Capsule: Picosalax and Prucalopride vs. PEG and Prucalopride
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Assessment of the Quality of the Bowel Preparation using a previously defined scale.
研究概览
简要总结
Colon capsule endoscopy is a technology that has been developed as a noninvasive method of examining the large bowel. The biggest limitation to its use has been finding a bowel preparation that will both clean the colon adequately for good visualization of the mucosa and also help propel the capsule through the colon. Most studies have been conducted in Europe using bowel preparation medications that are not approved for use in North America.
The purpose of this study is to compare a combination of polyethylene glycol (PEG) and prucalopride to Picosalax and prucalopride to determine which regime will give a better colon cleanse for the colon capsule. Both PEG and Picosalax are bowel preparations that are used routinely for colonoscopy in Canada. Prucalopride is a new medication recently approved for use in Canada which improves intestinal motility and should help with colon capsule transit.
Patients who are being referred for colonoscopy will be enrolled in the study and randomized to one of the bowel preparation regimes. They will undergo a split-dose bowel preparation with either PEG or Picosalax, which is routine for colonoscopy. As part of the standard bowel preparation, patients randomized to the Picosalax group will take dulcolax three nights before the test and then again two nights before the test. The evening before the test patients will take either PEG 2L or one sachet of Picosalax. The following morning they will take another dose of either PEG (2 Liter container) or one sachet of Picosalax. They will then ingest the colon capsule and a dose of Prucalopride that morning. After 7 hours they will return to the endoscopy unit where they will undergo a colonoscopy, which is the standard of care for examination of the colon.
The images from the colon capsule will be reviewed and the quality of bowel preparation will be graded using a previously validated scale. It is hypothesized that the Picosalax and prucalopride regime will give a better cleanse for the colon than PEG and prucalopride as there will be less turbid fluid in the colon and allow for a better view of the mucosa. Polyp detection and abnormalities of the mucosa detected with the colon capsule will also be compared to polyps and abnormalities detected at the time of colonoscopy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Male and female patients between the ages of 18 and 75
- •Patients being referred for colonoscopy
排除标准
- •Symptoms of dysphagia
- •Bowel obstruction or ileus
- •Known stricture or fistula
- •Inflammatory bowel disease
- •Previous small or large bowel surgery
- •Severe gastroparesis or motility disorder
- •Renal impairment (GFR<55 within 3 months of study)
- •Congestive heart failure (NYHA III or IV)
- •Ischemic heart disease
- •Cirrhosis or severe hepatic dysfunction (ascites or lab result INR>2)
- •History of serious arrhythmia
- •Pregnancy
研究组 & 干预措施
PEG and Prucalopride
干预措施: PEG (Drug)
PEG and Prucalopride
干预措施: Prucalopride (Drug)
PEG and Prucalopride
干预措施: Colon capsule (Procedure)
PEG and Prucalopride
干预措施: Colonoscopy (Procedure)
Picosalax and Prucalopride
干预措施: Prucalopride (Drug)
Picosalax and Prucalopride
干预措施: Picosalax (Drug)
Picosalax and Prucalopride
干预措施: Bisacodyl (Drug)
Picosalax and Prucalopride
干预措施: Colon capsule (Procedure)
Picosalax and Prucalopride
干预措施: Colonoscopy (Procedure)
结局指标
主要结局
Assessment of the Quality of the Bowel Preparation using a previously defined scale.
时间窗: Assessed at the time of review of the colon capsule images (from ingestion of capsule until the capsule is passed or the battery runs out--max 10 hrs) and at the time of colonoscopy on the same day (using a previously defined scale as described)
Cleansing Scale: * Poor: Mucosa obscured by opaque debris or turbid fluid * Fair: Portion of the mucosa obscured by turbid fluid and/or debris preventing visualization of polyps \>5mm in size * Good: Fluid was clear and small pieces of debris not obscuring polyps \>5mm * Excellent: Fluid was clear and either free of debris or only small pieces Bubble effect scale: * Significant: Bubbles interfere with the examination, \>10% surface area obscured by bubbles. * Insignificant: No bubbles or bubbles that do not interfere with the examination, \<10% of surface area obscured by bubbles.
Number of individuals who have a complete colon capsule study (ie. pass the colon capsule prior to colonoscopy)
时间窗: Assessed during the time of colon capsule image review
次要结局
- Assessment of patient tolerance of the bowel preparations.(Assessed at the time of colon capsule ingestion (will cover time period from beginning of bowel preparation, as previously described, to ingestion of the colon capsule))
- Gastric emptying and small and large bowel transit time(Assessed at the time the colon capsule images are reviewed (will be monitored from time of capsule ingestion until capsule is expelled or battery runs out--max 10 hours))
- Comparison of accurate identification of mucosal changes (ie. inflammation) and polyp detection with colonoscopy.(Determined at the time of review of the colon capsule images (assessed from time of capsule ingestion until capsule is expelled or battery runs out--max. 10 hours) and assessed during the colonoscopy the same day.)
研究者
Dr. Lawrence Hookey
Principal Investigator
Queen's University