title: A pilot study of capsule endoscopy after a standard meal for the detection and grading of oesophageal varices in cirrhotic patients.
abstract: BACKGROUND
  Capsule endoscopy has been proposed as an alternative to fibreoptic endoscopy for oesophageal varices evaluation in cirrhotics. However, it shows only moderate sensitivity compared to fibreoptic endoscopy.
  
  
  OBJECTIVE
  To compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity.
  
  
  METHODS
  Twenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy.
  
  
  RESULTS
  Post-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%).
  
  
  CONCLUSIONS
  Post-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics.
authors.affiliation: Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Brigida Eleonora
authors.initials: BE
authors.lastname: Annicchiarico
authors.affiliation: Digestive Endoscopy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Riccioni
authors.affiliation: Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Siciliano
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, Ospedale Belcolle, Viterbo, Italy. Electronic address: melena.riccioni@rm.unicatt.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Urgesi
authors.affiliation: Digestive Endoscopy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spada
authors.affiliation: Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Caracciolo
authors.affiliation: Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Digestive Endoscopy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000209:etiology; D004945:Esophagoscopy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000209:etiology; D007558:Italy; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D062407:Meals; D008875:Middle Aged; D010865:Pilot Projects; D019518:Postprandial Period; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: Capsule endoscopy; Oesophageal varices; Portal hypertension