Capsule Endoscopy: Improving the Transit Time and the Image View

Abstract

Background: The capsule endoscopy (CE) record video images during natural propulsion through the small bowel. Practical experience has shown that visualization of the entire small bowel mucosa may sometimes be hindered by the presence of residual material. Shorting the transit times of the CE through the stomach and small bowel might help the time needed to read the CE as well the short life of the CE battery(7±1 hours) and may be insufficient to image the entire small bowel. Aims: To evaluate the effect of various methods of small bowel preparation on the quality of visualization of the entire small bowel mucosa. Material and Methods:. 95 patients underwent CE by easily swallowing the capsule. They were divided into three study groups according to the preparation used. Group A (n = 26) by polyethylene glycol liter (PEG) or with sodium phosphate (SP) 12 hours prior to the CE study. Group B (n = 29) by Erythromycin one hour prior to the CE study and Group C (n = 40) with no preparation. One (1.05%) case had no natural excretion. Visualization ranged from good through satisfactory and poor. Results: The mean emptying gastric time was 41.7±51.5 minutes and the transit time of the small bowel was 225±80.6 minutes. In elderly people the emptying gastric time was significantly longer (163.7 min.), in patient prepared by PEG or SP (P 0.05) compare to the other preparation. The gender and the presence pathology had no effect on the study group The grade of the cleaning of the all study group was 3.27±1.1, the worst quality of image were significantly (P= 0.05) in the Erythromycin group compare to the other sub-group. The age, gender and the presence pathology had no effect on the quality of the cleaning of the small bowel study group. One (1.05%) case had no natural excretion. Visualization ranged from good through satisfactory and poor. Conclusions: Erythromycin have shorter time in the stomach but have a negative effect on the quality of the image in the small bowel. The preparation with in PEG or SP have a negative effect on the transit time of the small. The quality of the visualization in Erythromycin group was the worst.