Effect of oral purgatives on gastric and small bowel transit time in capsule endoscopy.
BACKGROUND
During ingestible capsule endoscopy, video images are recorded throughout the device's natural propulsion through the digestive system. Shortening the transit time of the wireless video capsule through the stomach and small bowel could reduce the time needed to read and analyze the resultant images, utilize more effectively the short life of the capsule battery (7 +/- 1 hours) and make it possible to image the entire small bowel.


OBJECTIVE
To measure gastric and small bowel transit times, with and without preparation, using capsule endoscopy.


METHODS
Capsule transit times through the stomach, small bowel and colon were evaluated by analysis of the videos generated during the capsule's passage. The study group included 62 patients with small and large bowel pathologies (e.g., iron deficiency anemia, Crohn's disease). The patients were divided into three groups: prepared with polyethylene glycol (Group A, n = 9), prepared with sodium phosphate (Group B, n = 13), and with no preparation (Group C, n = 40).


RESULTS
The gastric emptying times were 20.4 +/- 15.2 minutes in group A, 55.7 +/- 45.1 in group B, and 48.3 +/- 28.7 in group C (P = 0.01). The capsule produced views of the cecum in only 49 of the 62 patients. The mean small bowel transit time for these 49 patients was 238.8 +/- 82.1 minutes, making the mean times for the groups (A,B,C) 148.9 +/- 32.6, 289.4 +/- 77.2 and 249.3 +/- 73.9 minutes respectively (P = 0.0001).


CONCLUSIONS
Compared to both SP and no preparation, preparation of the colon with PEG significantly shortened the transit time of the capsule through the stomach and small bowel.
Fireman
Zvi
Z
Departments of Gastroenterology, Hillel Yaffe Medical Center, Hadera, Israel. fireman@hillel-yaffe.health.gov.il
Kopelman
Yael
Y
Fish
Lev
L
Sternberg
Amos
A
Scapa
Eitan
E
Mahaina
Elisabeth
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D002214:Capsules; D002400:Cathartics / Q000494:pharmacology*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D004733:Enema; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000494:pharmacology*; D011092:Polyethylene Glycols / Q000494:pharmacology*; D014741:Video Recording
D002214:Capsules; D002400:Cathartics; D010710:Phosphates; D011092:Polyethylene Glycols; C018279:sodium phosphate