Carbonated soft drink for gastric preparation for magnetically controlled capsule endoscopy: An open-label randomized controlled trial.

Background: The clinical effectiveness of magnetically controlled capsule endoscopy (MCE) is well established. However, problems, such as abdominal distension, insufficient gastric filling, and prolonged gastric retention time, persist with MCE gastric preparations.

Aim: To compare gastric filling using a carbonated soft drink with that using pure water during MCE.

Methods: We performed an open-label randomised controlled trial at the Endoscopy Centre of Changhai Hospital in Shanghai. Patients aged 18-80 years, with or without gastrointestinal symptoms, scheduled for MCE were consecutively recruited. Those who provided informed consent were randomly assigned to the carbonated soft drink group (C group) or water group (W group) in a 1:1 ratio. For patients in the W group, 1000 mL of water was ingested to distend the stomach, whereas for patients in the C group, 550 mL of carbonated soft drink was provided, and patients were required to drink quickly while minimising burping. The primary endpoint was the number of patients with a gastric filling score of ≥ 4 within 5 minutes after the capsule entered the stomach.

Results: From December 3, 2020 to May 17, 2021, 252 patients (141 men), aged 18-77 years, were assigned to the C ( = 126) and W ( = 126) groups. For the primary outcome, 123 patients in the C group achieved a gastric filling score of ≥ 4 (97.62% 80.16%, < 0.0001). More patients in the C group had the highest gastric filling scores within the first 5 min (78.57% 29.37%, < 0.0001) and 10 minutes (54.76% 13.49%, < 0.0001) after the capsule entered the stomach. More patients in the W group required extra liquid for gastric refilling (1.59% 16.67%, < 0.0001). Transpyloric passage of the capsule under magnetic control was successfully performed in 43 patients in the C group ( < 0.0001), accompanied by a shorter gastric transit time (53.27 ± 53.83 minutes 71.12 ± 52.19 minutes, = 0.001).

Conclusion: Carbonated soft drinks demonstrated superior and more sustained gastric filling compared with those of water alone, with the potential to promote gastric emptying.