title: Small-bowel capsule endoscopy in patients with unexplained chronic abdominal pain: a systematic review.
abstract: BACKGROUND
  Patients frequently consult primary care physicians and gastroenterologists when experiencing chronic abdominal pain. Although its diagnostic efficacy in these settings is uncertain, small-bowel capsule endoscopy (SBCE) has been used to evaluate the unexplained reasons for abdominal pain.
  
  
  OBJECTIVE
  To evaluate the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain.
  
  
  METHODS
  We performed a retrospective review of publications reporting the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain and calculated the overall diagnostic yield.
  
  
  METHODS
  Two investigators independently searched studies from databases and analyzed the results.
  
  
  METHODS
  A total of 1520 patients from 21 studies were included.
  
  
  METHODS
  Small-bowel capsule endoscopy.
  
  
  METHODS
  Per-patient diagnostic yield, with 95% confidence intervals (CI), was evaluated by a random-effect model. Clear categorical analysis also was performed.
  
  
  RESULTS
  The pooled diagnostic yield of SBCE in patients with unexplained chronic abdominal pain was 20.9% (95% CI, 15.9%-25.9%), with high heterogeneity (I(2) = 80.0%; P ＜ .001). Inflammatory lesions were the most common (78.3%) positive findings, followed by tumors (9.0%).
  
  
  CONCLUSIONS
  Heterogeneity among studies, retrospective design, variable chronicity of abdominal pain, and different previous examinations before SBCE.
  
  
  CONCLUSIONS
  SBCE provides a noninvasive diagnostic tool for patients with unexplained chronic abdominal pain, but the diagnostic yield is limited (20.9%). Among patients with positive findings, inflammatory lesions are the most common.
authors.affiliation: Department of Gastroenterology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Xue
authors.affiliation: Department of Gastroenterology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
authors.forename: Xueqin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Liuhong
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Gastroenterology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Si
authors.affiliation: Institute of Gastroenterology, Zhejiang University, Hangzhou, China; Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Liangjing
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
authors.forename: Shujie
authors.initials: S
authors.lastname: Chen
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis*; D053704:Capsule Endoscopy / Q000379:methods*; D002446:Celiac Disease / Q000175:diagnosis; D002908:Chronic Disease; D003424:Crohn Disease / Q000175:diagnosis*; D004751:Enteritis / Q000175:diagnosis; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis; D007414:Intestinal Neoplasms / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*