Tegaserod Decreases Small Bowel Transit Times in Patients Undergoing Capsule Endoscopy

Abstract

Tegaserod Decreases Small Bowel Transit Times in Patients Undergoing Capsule Endoscopy Ira J. Schmelkin PURPOSE: Gastric and small bowel transit times vary widely in patients undergoing capsule endoscopy. Tegaserod and other prokinetic agents have been postulated to alter motility in these patients. We compared gastric emptying times and small bowel transit times in patients receiving a single dose of Tegaserod to those who did not receive any prokinetic agent. METHODS: In November 2003, 18 consecutive patients undergoing capsule endoscopy in a private gastroenterology office were given a 6mg tablet of Tegaserod at the time of capsule ingestion. Gastric emptying times, small bowel transit times, and colonic entry were recorded in the usual fashion. These times were compared to 261 previously performed procedures in which no Tegaserod was used. RESULTS: In the Tegaserod group, mean small bowel transit time was 171 minutes (range 22 to 314) and mean gastric emptying time was 43 minutes (range 3 to 180). In all 18 patients, the capsule reached the cecum. In the control group, mean small bowel transit time was 241 minutes (range 37 to 710 minutes), and mean gastric emptying time of 41 minutes (range 1 to 242 minutes). 9% (24 out of 261 patients) did not reach cecum. DISCUSSION: In patients who received a 6mg dose of Tegaserod at the time of capsule ingestion, there was a significant decrease inmean small bowel transit time, while there was no difference in gastric emptying time, when compared to control patients. Furthermore, in the Tegaserod group, 100% of the capsules reached the cecum. These findings may have practical implications in capsule endoscopy when studying patients with underlying dysmotility disorders. In addition, since most of the time spent in reviewing a capsule study is reading the small bowel segment, the use of Tegaserod would likely shorten reading times.