Analysis of Incomplete Examinations in Capsule Endoscopy

Abstract

Purpose: To evaluate procedure and patient related factors that may influence the likelihood of complete small bowel visualization in capsule endoscopy. Methods: All capsule endoscopy examinations performed at our institution between 3/03–8/04 were analyzed through review of endoscopy reports, medical records and telephone follow-up. One examination was excluded in which there was an immediate technical malfunction upon capsule ingestion. A total of 55 examinations were analyzed. Incomplete examinations were defined as studies in which the capsule did not reach the colon before the battery expired. The Student t test and the Fisher exact test were used for the statistical comparison of means and proportions between the complete and incomplete examinations. Variables not distributed normally were compared using the Wilcoxon rank sum test. Results: The completion rate or success of visualizing the entire small intestine was 64%. Gastric transit time was significantly longer in incomplete examinations vs. complete examinations (median 37.5 min vs. 16 min, p = 0.04). The indications and findings of the examinations were not significantly different between the two groups. There were no statistically significant differences in patient characteristics between the two groups with respect to age, sex, history of diabetes, abdominal surgery, chronic constipation/diarrhea, or the use of narcotic, anticholinergic or laxative medications. Conclusions: Prolonged gastric transit time was the only significant factor influencing the completion rate in capsule endoscopy examinations. Further controlled trials are warranted to determine if shortening gastric transit time through the use of prokinetic agents will increase the completion rate and yield of capsule endoscopy.