Bowel preparation after mid-gut tubing enhanced the efficacy and compliance of magnetic resonance enterography in Crohn's disease: a randomized controlled trial.

BACKGROUND

Magnetic resonance enterography (MRE) has become a routine intestinal imaging examination for Crohn's disease (CD). Sufficient bowel preparation is fundamental for MRE.

OBJECTIVES

To compare the efficacy and compliance of bowel preparation between through a mid-gut tube and oral administration for MRE in CD.

DESIGN

This was an open-label, prospective, multicenter, randomized controlled trial.

METHODS

Eligible patients were randomized at a 1:1 ratio into an oral group (bowel preparation by oral administration) and a tubing group (bowel preparation through a mid-gut tube). Bowel preparation for MRE included bowel cleaning and bowel distention. The primary outcomes were the degree of discomfort and grade of bowel distention. The secondary outcomes were diagnostic accuracy rate through MRE, mental stress, and bowel preparation method preference.

RESULTS

A total of 95 CD patients were included in the final analysis. Subjects in the tubing group complained of less vomiting during bowel preparation than those in the oral group (p < 0.05). The degree of nausea and bloating during bowel cleaning for MRE was lower in the tubing group than in the oral group (all p < 0.05). The distention grade was higher in the tubing group compared to the oral group in the splenic flexure of the colon and rectosigmoid colon. The tubing group demonstrated a higher overall diagnostic sensitivity in ulcers compared to the oral group (p = 0.048). Additionally, bowel preparation via the mid-gut tube ameliorated mental stress (p = 0.020) and increased bowel preparation preference (p < 0.001).

CONCLUSION

Bowel preparation through the mid-gut tube enhanced the efficacy and compliance for MRE in CD. This study highlighted the concept of physician-patient satisfaction using mid-gut tube for proper bowel preparation for MRE, enteral nutrition and microbial therapy.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT03541733, registered 5 May 2018.