Original ArticleComplete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide
Section snippets
Patients
A total of 157 patients underwent CE between May 2001 and December 2003. Indications included the following: obscure GI bleeding (119 patients); known or suspected small-bowel disease, including Crohn's disease (19); and abdominal pain (19) (Table 1). All patients had been referred for CE. Clinical and procedural parameters recorded prospectively, as well as findings at CE, are shown in Table 1.
Seven patients were excluded from analysis, because passage of the capsule was either delayed or
Group 1
The small intestine was examined completely in 63 of the 83 patients (76%) not given metoclopramide. In the 20 patients with an incomplete examination, the capsule remained in the stomach in two and in the small intestine in 18. In one of the latter patients, there also was considerable delay in the esophagus (351 minutes before capsule entered stomach), although the patient had no history or symptoms of esophageal dysfunction.
Gastric transit time was significantly longer in patients in whom
Discussion
This study has two important findings: (1) complete small-bowel transit occurs in only about three quarters of patients undergoing CE without a prokinetic agent, and (2) administration of metoclopramide significantly increases the likelihood of capsule transit through the entire small intestine. In the 83 patients who did not receive metoclopramide (Group 1), the most striking difference between those in whom the capsule did or did not reach the colon was the significantly longer time that the
Acknowledgment
Associate Professor Kai Lo provided statistical consultation for this study and his support is acknowledged.
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Presented at the Third International Conference on Capsule Endoscopy, February 29-March 3, 2004, Miami, Florida.