Su1264 PROLONGED INTESTINAL TRANSIT TIME INCREASES CAPSULE ENDOSCOPY DIAGNOSTIC YIELD

Abstract

Capsule endoscopy has become one of the most frequently used diagnostic methods for small bowel lesions. There is scarce evidence regarding variables that may increase the odds of identifying small bowel lesions with this endoscopic method. To describe variables associated with a higher probability of finding small bowel lesions on capsule endoscopy. A cross-sectional study was performed using our Department’s capsule endoscopy database from July 2012 to July 2017. Adult patients referred for capsule endoscopy in which capsule arrival to cecum was documented were included for analysis. For each case, the presence of any small bowel mucosal lesion was registered: erosions, ulcers, vascular ectasia, red spots, polyps, tumors or other findings. The following variables were also examined: age, gender, reason for referral, quality of small bowel cleansing, capsule intestinal transit time; the latter was defined as the time interval between the first duodenal image and the first cecal image. These variables were compared between those patients showing at least one lesion versus those without small bowel lesions. A univariate analysis with a subsequent multivariate analysis following a logistic regression model was performed to determine variables significantly associated with the presence of small bowel lesions. Overall 140 studies were analyzed; 90% of them were performed in the context of occult gastrointestinal bleeding. Median age of enrolled patients was 69 years (60-75) and 54.29% were male. Small bowel cleansing was adequate in 94.29% of patients; 68.57% showed at least one lesion on capsule endoscopy: the most common finding was vascular ectasia (42.86%). A non-significant difference was observed in terms of age between groups of comparison [70 (61-76) versus 63 (59-74), p=0.07]. No difference was found when comparing small bowel cleansing, gender or reason for referral. Intestinal transit time was significantly longer among those patients with a small bowel lesion [359 minutes (257-427) versus 279 minutes (200-333), p=0.05]. On multivariate analysis, age as well as intestinal time were significantly associated with the presence of at least one small bowel lesion on capsule endoscopy [OR 1.02 (1-1.06) and 1.09 (1.03-1.12), respectively]. Age and intestinal transit time were significantly associated with the presence of abnormal findings on capsule endoscopy.