Assessment of whole gut motility in adolescents using the wireless motility capsule test

Ilse Broekaert,Tanja Fritz,Christoph Hünseler

doi:10.1007/s00431-021-04295-6

Abstract

Functional gastrointestinal (GI) disorders are often associated with intestinal dysmotility representing a diagnostic challenge. A relatively new method is the wireless motility capsule (WMC) test, which continuously measures pH, pressure, temperature and regional transit times as it passes through the GI tract. In adults, the WMC test was approved for use in the diagnosis of gastroparesis and constipation by assessing GI transit and contractility. We performed the WMC test in nine adolescent patients aged 12–17 years with functional GI symptoms from July 2017 until February 2019. Abnormal transit times were detected in four patients. Three patients showed abnormal transit times of the upper GI tract: in two cases, contractility analysis revealed prolonged gastric retention, and in one patient, abnormal colonic transit was detected.Conclusion: The WMC test is a minimally invasive procedure with potential to expand future diagnostic opportunities for paediatric patients with functional GI disorders and suspected motility disturbances.What is Known:• The assessment of GI transit and contractility of the whole gut is possible with the WMC test which is approved for use in the diagnosis of gastroparesis and constipation in adults. What is New:• The WMC test is a non-invasive diagnostic tool with the potential to expand diagnostic opportunities in paediatric patients by assessing regional and whole gut motility.• In paediatric patients with functional GI disorders, the WMC test could help to make an adequate diagnosis and initiate appropriate therapy.

Highlights

Functional gastrointestinal (GI) disorders are often associated with visceral hypersensitivity and dysmotility
The assessment of GI transit and contractility of the whole gut is possible with the wireless motility capsule (WMC) test which is approved for use in the diagnosis of gastroparesis and constipation in adults
The WMC test has been approved for the assessment of regional and entire GI transit times, the evaluation of gastric emptying in gastroparesis and colonic transit in constipation [2, 3]

Summary

Introduction

Functional gastrointestinal (GI) disorders are often associated with visceral hypersensitivity and dysmotility. Several methods for assessing GI motility (e.g. antroduodenal or colonic manometry) or GI transit (e.g. scintigraphy) are available but are invasive or lead to radiation exposure. A relatively new, non-invasive method is the wireless motility capsule (WMC) test [1] analogously to the wireless capsule endoscopy which is routinely used in, e.g. inflammatory bowel disease or gastrointestinal bleeding. The WMC test has been approved for the assessment of regional and entire GI transit times, the evaluation of gastric emptying in gastroparesis and colonic transit in constipation [2, 3]. Green et al showed a sensitivity of 100% using the WMC test compared to scintigraphic gastric emptying studies to detect gastroparesis in 22 paediatric patients [4]. Rodriguez et al found no association between the WMC study and symptoms but a fair agreement with gastric scintigraphy and a strong agreement with colonic radiopaque marker studies [5]

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