Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study.
OBJECTIVE
Capsule endoscopy (CE) is approved for the evaluation of obscure gastrointestinal (GI) bleeding and its use has increased in the assessment of patients with various small-bowel disorders. The yield of CE for indications of disorders other than GI bleeding is not yet well described. The aim of the present study was to determine in which subgroup of patients with unexplained abdominal pain, CE would be a helpful evaluation tool.


METHODS
The results of CE in 110 patients (70 M, 40 F, mean age 50.8+/-14.1 years) with unexplained abdominal pain from 12 tertiary referral centers between September 2002 and September 2004 were retrospectively analyzed.


RESULTS
The visualization of the small bowel to the cecum was successfully carried out in 69.1% of the patients. Nineteen out of the 110 cases revealed positive findings that explained the symptoms of the patient (diagnostic yield=17.3%). Diagnosis included small-bowel stricture (5), Crohn's disease (3), small-bowel tumor (2), radiation-induced enteritis (1), NSAID-induced enteropathy (1), ischemic ileitis (1), diffuse lymphangiectasia (1), and significant erosion or ulceration (5). By univariate logistic regression analysis, the positive findings of CE were significantly associated with weight loss (odds ratio (OR), 11.9; 95% CI [2.0, 70.6]), elevated erythrocyte sedimentation rate (ESR) (>20 mm/h) (OR, 11.5; 95% CI (1.9, 69.5)), elevated C-reactive protein (CRP) (>or=0.4 mg/dL) (OR, 5.0; 95% CI (1.6, 15.9)), and hypoalbuminemia (albumin<3 g/dL) (OR, 23.1; 95% CI (2.4, 223.1)). Using a multivariate analysis, weight loss was found to be a significant risk factor for positive findings of CE (OR, 18.6; 95% CI (1.6, 222.4), p=0.02).


CONCLUSIONS
The results of this study suggest that CE can be helpful in patients suffering from abdominal pain that cannot be explained by established examinations, if the pain is accompanied by weight loss.
Shim
Ki-Nam
KN
Ewha Womans University College of Medicine, and Yang Hospital, Seoul, Korea.
Kim
Yong-Sik
YS
Kim
Kyung-Jo
KJ
Kim
Young-Ho
YH
Kim
Tae-Il
TI
Do
Jae-Hyuk
JH
Ryu
Ji-Kon
JK
Moon
Jeong-Seop
JS
Park
Soo-Heon
SH
Hee Park
Cheol
C
Lee
Kee-Myung
KM
Lee
In-Seok
IS
Chun
Hoon-Jai
HJ
Jung
In-Seop
IS
Choi
Myung-Gyu
MG
D015746:Abdominal Pain / Q000209:etiology*; D053704:Capsule Endoscopy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015431:Weight Loss