Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally adminis...Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally administered metoclopramide. Clinical and procedural parameters were recorded prospectively for 150 patients undergoing capsule endoscopy. Metoclopramide was not administered to the first 83 patients (Group 1) but was given orally (10 mg) to the subsequent 67 (Group 2). Small-bowel transit was complete in 63 patients in Group 1 (76%). Gastric transit time was significantly longer when the capsule did not reach the colon than when it did (114.9 ±32.6 minutes vs. 26.6 ±2.9 minutes; p = 0.007). Small-bowel transit time also was longer. The likelihood of complete small-bowel passage was not predicted by any clinical or procedural factor. In Group 2 (metoclopramide), the capsule reached the colon in 65 (97%) patients (OR 10.3: 95%CI[2.32, 93.55], p < 0.001). This improvement was associated with a significant reduction in gastric transit time (47.9 ±9.0 minutes vs. 30.8 ±7.5 minutes; p = 0.025). Metoclopramide increases the likelihood of a complete small-bowel examination in patients undergoing capsule endoscopy.展开更多
Background: Approximately two thirds of patients undergoing capsule endoscopy for obscure GI bleeding will have an abnormality found in the small intestine. This report describes 9 patients (4 men, 5 women) of 140 wit...Background: Approximately two thirds of patients undergoing capsule endoscopy for obscure GI bleeding will have an abnormality found in the small intestine. This report describes 9 patients (4 men, 5 women) of 140 with obscure bleeding in whom a source of their blood loss was found in the stomach or the colon at capsule endoscopy. Methods: A review was made of a prospective database of 140 consecutive patients undergoing capsule endoscopy for obscure GI bleeding at a single center. Patients with a definite or likely cause of bleeding within reach of conventional upper or lower GI endoscopy were identified. Results: Three patients had gastric antral vascular ectasia and another an inflamed pyloric canal polyp. Two patients had actively bleeding cecal carcinoma, missed at previous colonoscopies. Two others had bleeding cecal angiodysplasia. The final patient had severe nonspecific cecal inflammation. The identification of these lesions was aided by the suspected blood indicator. All patients underwent endoscopic therapy or surgery for their non-small-bowel lesions. Conclusions: Like push enteroscopy, capsule endoscopy also can identify lesions within reach of conventional endoscopy and colonoscopy. These subsequently can be treated successfully. The reasons why these lesions have been missed are unclear.展开更多
文摘Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally administered metoclopramide. Clinical and procedural parameters were recorded prospectively for 150 patients undergoing capsule endoscopy. Metoclopramide was not administered to the first 83 patients (Group 1) but was given orally (10 mg) to the subsequent 67 (Group 2). Small-bowel transit was complete in 63 patients in Group 1 (76%). Gastric transit time was significantly longer when the capsule did not reach the colon than when it did (114.9 ±32.6 minutes vs. 26.6 ±2.9 minutes; p = 0.007). Small-bowel transit time also was longer. The likelihood of complete small-bowel passage was not predicted by any clinical or procedural factor. In Group 2 (metoclopramide), the capsule reached the colon in 65 (97%) patients (OR 10.3: 95%CI[2.32, 93.55], p < 0.001). This improvement was associated with a significant reduction in gastric transit time (47.9 ±9.0 minutes vs. 30.8 ±7.5 minutes; p = 0.025). Metoclopramide increases the likelihood of a complete small-bowel examination in patients undergoing capsule endoscopy.
文摘Background: Approximately two thirds of patients undergoing capsule endoscopy for obscure GI bleeding will have an abnormality found in the small intestine. This report describes 9 patients (4 men, 5 women) of 140 with obscure bleeding in whom a source of their blood loss was found in the stomach or the colon at capsule endoscopy. Methods: A review was made of a prospective database of 140 consecutive patients undergoing capsule endoscopy for obscure GI bleeding at a single center. Patients with a definite or likely cause of bleeding within reach of conventional upper or lower GI endoscopy were identified. Results: Three patients had gastric antral vascular ectasia and another an inflamed pyloric canal polyp. Two patients had actively bleeding cecal carcinoma, missed at previous colonoscopies. Two others had bleeding cecal angiodysplasia. The final patient had severe nonspecific cecal inflammation. The identification of these lesions was aided by the suspected blood indicator. All patients underwent endoscopic therapy or surgery for their non-small-bowel lesions. Conclusions: Like push enteroscopy, capsule endoscopy also can identify lesions within reach of conventional endoscopy and colonoscopy. These subsequently can be treated successfully. The reasons why these lesions have been missed are unclear.
