Tegaserod Increase Colonic Entry Rate in Patients Undergoing Capsule Endoscopy

Abstract

Purpose: Capsule endoscopy (CE) is one of the valuable diagnostic methods for the small bowel disease. Despite of high diagnostic yields of capsule endoscopy in patients with small bowel disease, limited battery time may prevent it from reaching its enormous diagnostic potential. We performed this study to investigate the effect of tegaserod on the gastric, small bowel transit time and the rate of colonic entry. Methods: In November 2003, 25 consecutive patients undergoing CE in a community hospital swallowed one 6mg tablets of tegaserod at 30 minutes before and 4 hours after capsule ingestion respectively. Capsule transit times were evaluated by analysis of the videos generated during CE passage automatically. These times were compared to 35 previously performed procedures in which no prokinetics was used. We prescribe patients with 2-4L of polyethylene glycol to be taken the night before the test. We only included 24 and 34 patients without stricture in each group. Results: In the tegaserod group, mean small bowel transit time was 231minutes (range 78 to 424) and mean gastric emptying time was 31 minutes (range 5 to 113). In 21 out of 24 (87%) patients, the capsule reached the cecum. In the control group, mean small bowel transit time was 261 minutes (range 105 to 350 minutes), and mean gastric emptying time was 52 minutes (range 2 to 352 minutes). 17 out of 34 (50%) patients reached cecum. The mean small bowel transit time in tegaserod group was shorter than placebo. Conclusions: Tegaserod seems to be improved complete small bowel evaluation rate by shortening gastric transit time. Even though statistical significance was not found (p > 0.05), tegaserod showed the tendency to shorten the small transit time. Prescription of tegaserod may improve complete small bowel evaluation rate in performing capsule endoscopy.