title: The relationship between physical activity level and completion rate of small bowel examination in patients undergoing capsule endoscopy.
abstract: OBJECTIVE
  Capsule endoscopy (CE) allows direct examination of the small bowel in a safe, noninvasive and well-tolerated manner. Nonetheless, experience indicates failure to reach the cecum in 20-30% of patients within the 8 hour battery life. Attempts to improve the completion rate (CR) as defined by reaching the cecum have been unsuccessful. This study was to investigate the relationship between patients' physical activity and CR.
  
  
  METHODS
  Between January 2009 and January 2010, 76 patients (44 men, 32 women; median age 64.5 yr) underwent CE for the diagnosis of small intestinal disorders. Indications for CE were obscure gastrointestinal bleeding/anemia (62 cases), others (14 cases). Patients were divided into an outpatient group (n=23), mild bed rest group (n=35) and strict bed rest group (n=18).
  
  
  RESULTS
  For all patients, the average gastric transit time was 65.5 minutes, small bowel transit time was 301.4 minutes and the CR was 86.8%. However, the CR was 100% (23/23) in the outpatient group, an 85.7% (30/35) in the mild bed rest group, and 72.2% (13/18) in the strict bed rest group. The CR increased with physical activity of patients by Cochran-Armitage Trend Test (p=0.009). In multivariate logistic regression analyses, low physical activity was a significant risk factor for failure to reach the cecum during CE examination; adjusted OR: 3.39, 95% CI: 1.01-11.42 (p=0.048).
  
  
  CONCLUSIONS
  Our observations suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. Further, for CE, inconvenient bowel preparations like the use of polyethylene glycol may be avoided.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, Japan. tomoyosi@juntendo.ac.jp
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeda
authors.forename: Masae
authors.initials: M
authors.lastname: Konishi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fukuo
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Kazuko
authors.initials: K
authors.lastname: Beppu
authors.forename: Naoto
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Michiro
authors.initials: M
authors.lastname: Otaka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ogihara
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000503:physiopathology; D007421:Intestine, Small / Q000473:pathology* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D055815:Young Adult