title: Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: a Greek multicenter study.
abstract: BACKGROUND
  Wireless capsule endoscopy has become the gold standard for the examination of small bowel. However, its role in the evaluation of patients suffering from chronic abdominal pain is not yet clearly defined. We conducted an open-label prospective multi-center study to evaluate the yield and clinical outcome of capsule endoscopy in patients with chronic abdominal pain with/without diarrhea.
  
  
  METHODS
  Seventy-two patients with chronic (>3months) abdominal pain with/without diarrhea in whom the underlying pathology could not be diagnosed by conventional modalities, underwent capsule endoscopy in either of the 6 participating centers. Patients were then followed up for clinical outcomes.
  
  
  RESULTS
  The overall diagnostic yield of capsule endoscopy was 44.4%. More specifically, its diagnostic yield was 21.4% in patients with abdominal pain and negative inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), 66.7% in patients with abdominal pain and positive inflammatory markers, 0% in patients with abdominal pain, diarrhea and negative inflammatory markers, and 90.1% in patients with abdominal pain, diarrhea and positive inflammatory markers. Both univariate and multivariate regression analyses showed that abnormal C-reactive protein and erythrocyte sedimentation rate were significant factors related with positive capsule endoscopy findings.
  
  
  CONCLUSIONS
  Chronic abdominal pain with/without diarrhea should be accompanied by elevated inflammatory markers to be regarded as a valid indication for capsule endoscopy. The yield of capsule endoscopy in such patients is reasonably high and clinical outcomes of patients treated with capsule endoscopy findings as a guide are significant.
authors.affiliation: Department of Endoscopy and Motility Unit, G.Gennimatas General Hospital, Thessaloniki, Greece. gchatzimav@yahoo.gr
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Katsinelos
authors.forename: Kostas
authors.initials: K
authors.lastname: Fasoulas
authors.forename: Athanasios
authors.initials: A
authors.lastname: Beltsis
authors.forename: Grigoris
authors.initials: G
authors.lastname: Chatzimavroudis
authors.forename: George
authors.initials: G
authors.lastname: Paroutoglou
authors.forename: Theofanis
authors.initials: T
authors.lastname: Maris
authors.forename: Kostas
authors.initials: K
authors.lastname: Mimidis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Koufokotsios
authors.forename: Sotiris
authors.initials: S
authors.lastname: Terzoudis
authors.forename: Stefanos
authors.initials: S
authors.lastname: Atmatzidis
authors.forename: Agoritsa
authors.initials: A
authors.lastname: Kaltsa
authors.forename: Dimitris
authors.initials: D
authors.lastname: Kapetanos
authors.forename: Eustathios
authors.initials: E
authors.lastname: Kamperis
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
authors.forename: Aristea
authors.initials: A
authors.lastname: Belou
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D059350:Chronic Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult