Bowel Transit Time Research Articles

Effects on gastrointestinal transit and antroduodenojejunal manometry after gut-directed hypnotherapy in irritable bowel syndrome (IBS)

Background.Gut-directed hypnotherapy is an effective treatment in irritable bowel syndrome (IBS) but little is known about the mechanisms of action. In this study we aimed to investigate the effects on gastrointestinal motility when treating IBS with gut-directed hypnotherapy. Methods.We randomized 90 patients with IBS, refractory to standard management to receive gut-directed hypnotherapy 1 h/week for 12 weeks or supportive treatment for the same time period. Eighty-one subjects (40 hypnotherapy, 41 controls) could be evaluated by one or more of the following investigations, both before and after the intervention: gastric emptying time, small bowel transit time, colonic transit time, and antroduodenojejunal manometry. Results. No significant differences in gastric emptying time, small bowel transit time, or colonic transit time was found when comparing the baseline and post-intervention measurements in the hypnotherapy group or in the control group. The same was true concerning the results of the antroduodenojejunal manometry. However, there was a numerical trend toward a higher number of migrating motor complexes at manometry and an accelerated gastric emptying time after hypnotherapy that did not reach statistical significance. Conclusions.In this study, we were not able to find evidence for long-standing effects on gastrointestinal motility as a mediator of the effects on IBS when treating the condition with gut-directed hypnotherapy. Further research to understand the mechanism of action is needed.

Assessment of Gastrointestinal Transit Time Using Video Capsule Endoscopy

Purpose: Video capsule endoscopy (VCE) is a procedure that uses a wireless camera to take pictures of the gastrointestinal tract. This is most frequently used for evaluating obscure gastrointestinal bleeding. A wireless motility capsule (WMC) of a similar size has been developed, which measures pH, pressure, and temperature, and can be used to assess regional and total gastrointestinal transit times. VCE could also potentially be used as a tool for measuring GI transit time, but here is limited data on gastric empying time (GET) and small bowel transit time (SBTT) using VCE and normal ranges are not standardized.Table: [1726] GET and SBTT as determined by video capsule endoscopy (VCE) compared with wireless motility capsule (WMC) dataMethods: In order to obtain GI transit data and compare results of VCE with those of WMC, we did a retrospective study using data from VCE (PillCam, Given Imaging) performed between 2003-2007 in a county hospital setting. Patients were included if the indication for VCE was either iron deficiency anemia (IDA) or overt obscure GI bleed (OOGIB) and they had no known motility disorder. GET and SBTT (median with 25th-75th percentile) were compared between groups. Results from VCE were also compared with those from healthy controls who were studied with the WMC (SmartPill). Results: There were a total of 147 VCE studies performed, including 42 for OOGIB and 105 for IDA. Mean age (±SD) in the total group was 57.9 ±14.2, 94 (64%) were female, and 135 (92%) were Hispanic. The VCE did not reach the duodenum by the end of the study in 8 of 147 patients (5.4%), so these results were not included in the analysis. Using a linear regression analysis, age and gender had no significant effect on GET. There was a weak inverse linear association between GET and SBTT (r=0.19, p< 0.04). GET and SBTT in the IDA group was not significantly different compared with the OOGIB group. However, GET and SBTT were significantly faster in both groups when compared with WMC data as the gold standard for measuring GI transit time. The table outlines values for patients with OOGIB, IDA, total VCE studies, and 66 healthy controls in WMC studies. Conclusion: 1) GET and SBTT using VCE is not significantly different in OOGIB compared with IDA. 2) Both GET and SBTT are significantly faster in VCE compared with WMC measurements. This is mainly explained by differences in methods of preparation, with VCE performed in the fasting state when phase III migratory motor complexes regularly sweep the GI tract, while WMC is performed after a standardized solid meal where migratory motor complexes are delayed until the digestible solid food is emptied. In summary, VCE could potentially be used for measuring GI transit time in the fasting state and we provide new criteria for normal GET and SBTT.

Role of Capsule Study in Evaluation of Irritable Bowel Syndrome

Purpose: Introduction: Irritable bowel syndrome (IBS) is a common disorder that accounts for one-third of the referrals to a gastroenterologist. Most patients diagnosed with IBS have had limited or no evaluation for pathology of the small bowel or for presence of abnormal transit time. Capsule endoscopy is a non-invasive method of imaging the small bowel and measuring transit time. The purpose of this study is to measure the prevalence of small bowel mucosal pathology in diarrhea dominant or mixed bowel pattern IBS patient and to measure differences in transit time. Methods: Prospective study participants at Naval Medical Center Portsmouth qualified for Rome III criteria of diarrhea and mixed type IBS and had no alarm symptoms. Each patient underwent capsule study and images were evaluated by a gastroenterologist. Gastric transit time and small bowel transit time were determined by landmark identification using the GIVENTM capsule system. Post-hoc analysis was performed for transit time differences and two-tailed paired t-test was performed. P-values were determined using two tails. Results: 20 of the patients enrolled were alternating types and 30 were diarrhea dominant types. Two diarrhea types were excluded from study final transit time results, one due to obscured camera view and the other secondary to the capsule being inserted below the pylorus by endoscopy. No small bowel pathology was found in all patients. The mean gastric transit time for the alternating type was 46.9 minutes (SD 42.21) and for the diarrhea dominant type was 46.75 minutes (SD 50.94), P =0.9914. The mean for small bowel transit time was 261.9 minutes (SD 89.33) for alternating type and 178.21 minutes (SD 70.87) for diarrhea dominant type, P=0.0007. Conclusion: No small bowel pathology was found in all IBS patients and supports ACG position statement concerning evaluation of IBS patients. However, capsule endoscopy was able to document statistically significant small bowel transit time differences between IBS patients who had diarrhea predominate symptoms and alternating predominate symptoms. The use of capsule technology may help direct medical management in complex IBS patients.

Food transit time, nutrient digestibility and nitrogen retention in farmed and feral American mink (Neovison vison) – a comparative analysis

The aim of this study was to determine whether farming leads to changes in gastrointestinal function and nitrogen metabolism in farmed mink (FA), as compared with their wild-living counterparts. Three digestibility and balance trials were carried out. Experiment I was performed in May, and experiments II and III were conducted in September 2011. Farmed mink with the standard coat colour were purchased from a production farm in south-eastern Poland. Feral mink were harvested using cages in the hunting grounds of the Polish Hunting Association, Branch in Olsztyn. The experimental materials comprised of the following: trial I - adult males (eight animals per group), trial II - young females (six animals per group), trial III-young animals (five males and five females per group). Food transit time was measured during digestibility trials, on 10 consecutive days. The coefficients of nutrient and energy digestibility and daily nitrogen balance values were compared between groups in each experiment. It was found that farming contributed to changes in gastrointestinal function and nitrogen metabolism in mink. Farmed animals were characterized by a longer bowel transit time, a tendency towards higher nutrient digestibility and higher nitrogen retention, which resulted from selection for higher productivity.

Effects of the Oral Administration of Mosapride Citrate on Capsule Endoscopy Completion Rate

Background/AimsIn capsule endoscopy (CE), the capsule does not always reach the cecum within its battery life, which may reduce its diagnostic yield. We evaluated the effect of mosapride citrate, a 5-hydroxytryptamine-4 agonist that increases gastrointestinal motility, on CE completion.MethodsIn a retrospective study, we performed univariate and multivariate analyses for 232 CE procedures performed at our hospital. To identify factors that affect CE completion, the following data were systematically collected: gender, age, gastric transit time (GTT), nonsteroidal anti-inflammatory drug administration, previous abdominal surgery, hospitalization, use of a polyethylene glycol solution, use of mosapride citrate (10 mg), body mass index (BMI), and total recording time.ResultsThe univariate analysis showed that oral mosapride citrate, GTT, and BMI were associated with improved CE completion. Multivariate analyses showed that oral mosapride citrate (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.01 to 3.91) and GTT (OR, 2.34; 95% CI, 1.13 to 4.87) were significant factors for improving the CE completion. Oral mosapride citrate significantly shortened the GTT and small bowel transit time (SBTT).ConclusionsOral mosapride citrate reduced the GTT and SBTT during CE and improved the CE completion rate.

Effect of capsule placement with transnasal endoscopy

One of the prohibiting factors in achieving complete small bowel capsule endoscopy is slow gastric transit of the capsule. The present study retrospectively investigated the success rate of, and the time required for, transnasal endoscope-assisted capsule placement to assess its clinical utility. In 24 of 27 patients who underwent capsule placement assisted by a transnasal endoscope, the capsule was successfully transported to and released in the duodenum (capsule placement group). For each patient in the capsule placement group, three age- and sex-matched patients who underwent conventional capsule endoscopy were assigned as controls (n=72). Gastric transit time, small bowel transit time, and rate of capsule arrival at the cecum within 8h were compared between the two patient groups. Among the 27 patients in whom capsule placement was carried out, the capsule was successfully placed in the duodenum in 24 patients (88.9% success rate). In the capsule placement group, gastric transit time was significantly shorter (10.5 vs 46.2min, P=0.0021), small bowel transit time was significantly longer (354.7 vs 301.3min, P=0.0134), and completion rate (capsule arrival at the cecum within 8h) was significantly higher (83.3 vs 61.1%, P=0.0455) than in the control group. There were no procedural accidents associated with capsule placement. Transnasal endoscope-assisted capsule placement appears to be a safe and reliable procedure, achieving complete small bowel capsule endoscopy, and is considered clinically useful.

PTU-227 Improving efficiency in capsule endoscopy: can reading times be reduced without sacrificing diagnostic accuracy? A self-assessment

IntroductionCapsule endoscopy (CE) is a time consuming procedure. The RAPID 7 Access reading software (Given Imaging Ltd) has three patterns of view modes (VM) (one view, VM1; double views, VM2;...

Small bowel transit time in patients undergoing capsule endoscopy: Analyzis of determining factors

Background and aim: The quality of a capsule endoscopy (CE) study is largely dependent upon small bowel capsule transit time (SBTT) through the small intestine. Decreased SBTT during CE impaires visualisation of the entire small bowel mucosa. In contrary, prolonged SBTT during CE may be associated with a higher diagnostic yield. We aimed to identify certain risk factors that may help to predict either rapid or delayed SBTT. Patients and methods: A total of 54 consecutive patients undergoing CE without the use of promotility agents were reviewed for the study. Indications for CE were obscure gastrointestinal bleeding or anaemia of unknown origin. Patients received a standard bowel preparation that consisted of a low-residue diet for 24 hours, fluid intake, and ingestion of 4l polypethylene-glycol solution swallowing the PillCam (SB2 Given Imaging capsule). SBTT was calculated by substracting the time of first duodenal image from the time of first cecal image. Patients who experienced capsule failure in reading the coecum were excluded from the analysis. Covariates of patient demographics were analyzed to detect positive associations with SBTT. Results: The mean SBTT was 256.9 minutes (4.3 hrs), with a range between 31 and 469 minutes. Most patients (n=37, 68.5%) recorded a SBTT of 120–350 minutes. T-probe analysis demonstrated a lack of association between SBTT and patient gender, age, quality of bowel preparation, body mass index, hospital status, comorbidity and concomitant medication. There was a trend towards longer SBTT in patients on β-blocker therapy and with an excellent bowel preparation. Conclusions: Small bowel transit time during capsule endoscopy does not appear to be related to factors such as patient age, gender, hospital status, body mass index and quality of bowel preparation. A trend of longer small bowel transit time was detected in patient on β-blocker co-medication and with excellent bowel preparation.

A Prospective Randomized Trial of Mosapride vs. Placebo in Constipation-Predominant Irritable Bowel Syndrome

To the Editor: Irritable bowel syndrome (IBS) is a common disorder affecting ~5% of adults and comprising 28% of gastroenterology practice (1,2). Treatment of IBS remains a challenge because of its poorly defined pathophysiology, high placebo response, and variable symptomatology (3). Mosapride citrate, a selective partial 5–HT4 receptor agonist, which enhances gastrointestinal motility after accelerating the release of acetylcholine from nerves in the gastrointestinal tract (4), has been shown to accelerate colonic motility in animals (5). A small Japanese study (6) involving 11 patients with constipation-predominant IBS (C-IBS) showed that mosapride reduced abdominal pain and distention, decreased flatus, shortened bowel transit time, and produced looser stools, suggesting that mosapride may be useful in C-IBS.

216 Improved Diagnostic Yield With Early Video Capsule Endoscopy After Diagnosis of Obscure Gastrointestinal Bleeding

asymptomatic individuals to quantify the amount of injury and attempt to determine baseline scores. Methods: Healthy volunteers were recruited for this IRB-approved study. Subjects were excluded if they had taken any NSAIDs in the two weeks prior to enrollment . Other exclusion criteria included pregnancy, implanted medical devices, a history of Crohn's disease, a previous small bowel resection, a history of anklyosing spondylitis, and gastrointestinal symptoms of diarrhea, abdominal pain or nausea. CE exams were performed after fasting and the administration of simethicone prior to capsule ingestion. All studies were read at a fixed frame rate of 7fps in a quad view. Mucosal breaks were defined as lesions with white or yellow centers and a red border. Scores were determined according to the Lewis Score. Results: 34 volunteers participated in the study (17/34 male, mean age 27 years [range 18-43]). The capsule reached the colon in 31/34 (91%) of exams. All studies were of good or excellent quality. The mean small bowel transit time was 249 minutes (range 78-404 minutes). 31/34 (91%) volunteers received a Lewis Score of zero. Three CE studies had a Lewis Score of 450 for small mucosal breaks in the first and middle tertiles of the small intestine. This score is consistent with mild mucosal injury. There were no adverse events in any of the participants. Conclusion: These results demonstrate that 9% of healthy individuals who do not use NSAIDs will have mucosal breaks on CE with Lewis Scores that do not surpass 450. The percentage of healthy volunteers with mucosal breaks is consistent with prior studies that included healthy individuals. Parameters and relative weight values used to analyze each tertile of small bowel

149 The Effect of Chewing Gum on Small Bowel Transit Time: A Prospective Randomized Trial

149 The Effect of Chewing Gum on Small Bowel Transit Time: A Prospective Randomized Trial

Sa1750 The Most Effectible Dose of Mosapride Citrate on the Examination for Small Bowel Capsule Endoscopy in Healthy Subjects: A Prospective Double-Blind Cross-Over Study

The Most Effectible Dose of Mosapride Citrate on the Examination for Small Bowel Capsule Endoscopy in Healthy Subjects: A Prospective Double-Blind Cross-Over Study Mari Hayashida*, Shin’Ichi Takahashi Kyorin University School of Internal Medicine, Tokyo, Japan Aims: The aim of this study was to evaluate the efficacy dose of mosapride citrate on the intestinal-transit time. Methods: We reported the 10mg mosapride citrate efficacy on intestinal-transit time and diagnostic yield of CE. 10mg mosapride citrate markedly shortened the gastric transit time but without statistical significance (16.2min. in mosapride citrate group vs 44.4 min. in the placebo group). No significant difference was found in the small bowel transit time (193 min. in mosapride citrate group vs 196 min. in the placebo group). The study was performed in 10 healthy male volunteers, aged 31-44 yrs (mean age: 38 yrs). They were given informed consent before the study. This was a prospective, and double-blind cross-over study. After overnight fasting, they were given a single dose of 20mg mosapride (group 20mgM) or placebo (group P) one hour before CE examination. The intestinal-transit time and the number of reaching the cecum within 8 hours were evaluated for each group. After then the gastric transit time and small bowel transit time were evaluated between mosapride citrate 10mg group and 20mg group. Results: All subjects had a complete examination with capsule reaching the cecum in time. The gastric transit time in the group 20mgM was statistical significant shortened (11.8 min in group 20mgM vs 42.2 min in group P. p 0.05). The small bowel transit time in the group 20mgM was also statistical significant shortened (113 min in group 20mgM vs 236 min in group P. p 0.05). No significant difference was found in the gastric transit time between 10mg and 20mg mosapride citrate group (16.2 min vs 11.8 min). But the small bowel transit time between 10mg and 20mg mosapride citrate group was statistical significant shortened in group 20mgM (193min vs 113 min). Conclusion: We suggested that 20mg mosapride citrate is the most efficacy dose on the examination of small bowel CE.

Clinical value of right lateral position with real-time monitor for capsule endoscopy

Objective To investigate the clinical value of right lateral position with real-time moni- tor for capsule endoscopy. Methods A total of 80 patients were randomly divided into two groups. The observation group assumed the right lateral position, while the control group was in upright, standing or sitting position. The capsule endoscope was monitored real time. The patients were allowed to move after the cap- sule endoscope passed pylorus. Gastric transit time, small bowel transit time, small bowel examination com- pletion rate and positive detection rate were compared between the two groups. Results The mean gastric transit time of the observation group was （31.7 ± 29. 8 ）min , which was significantly shorter than that in the control group （ 62. 6 ±55.9 ） min （ U = 559. 000, P = 0. 020 ）. The mean transit time of small bowel was （221.3 ± 78.8 ） min in the observation group, which was not significantly different from that of the control group （ t = 0. 511, P = 0. 611 ）. The examination completion rate of whole small bowel was 95.0% （38/40） in the observation group, which was significantly higher than that of the control group （X2 = 5. 165, P = 0. 023 ）. The positive detection rates were 75.0% （30/40） and 65.0% （26/40）, respectively, which were not significantly different （X2 = 0. 952, P = 0. 329）. Conclusion The right lateral position with real-time monitor during capsule endoscopy is of better clinical value. Key words: Capsule endoscopy; Real-time monitoring; Right lateral position

Effect of metoclopramide on capsule endoscopy examination: a randomized study

To investigate the effect of metoclopramide on capsule endoscopy (CE) examination. Total 116 patients referred for CE were randomized into two groups with 58 patients in each group. In treatment group patients received 10 mg metoclopramide intramuscular injection after swallowing the capsule and in control group no metoclopramide was administered. The gastric transit time, small bowel transit time, complete endoscopy rate were observed in both groups. The CE examination was completed in 51 patients of treatment group (87.9%) and 48 of control group (84.2%). Mean gastric transit time was (32.45 ± 29.63) min in treatment group and (45.81 ± 40.01)min in control group, there was significant difference between two groups (P<0.05). Mean small bowel transit time was (252.69 ± 113.29) min in treatment group and (258.75 ± 83.83) min in control group, there was no significant difference between two groups (P>0.05). Metoclopramide may reduces gastric transit time, but not effect small bowel transit time,which suggests that it might increase the likelihood of complete small-bowel examination in patients undergoing capsule endoscopy.

P205 A new rapid test for fecal calprotectin (FC) predicts mucosal healing in ulcerative colitis (UC)

tertiary IBD center were reviewed. Inclusion criteria: (1) Small bowel CD assessed by conventional techniques; (2) Detailed clinical history; (3) No stenosis/obstructions; (4) Small bowelCD assessed by entero-CT/-MRI, small intestinal contrast ultrasonography, barium follow through and/or ileocolonoscopy (IC) within 6mths from SBCE; (5) SBCE images reviewed by one single gastroenterologist. SBCE performed using the Given Pillcam SB (Given, Israel) after 2L PEG. Findings considered: (a) CD extent before vs after SBCE; (b) upper GI lesions (i.e. above the distal ileum proximal to the valve or to the anastomosis); (c) SBCE transit times; (d) impact rate. Results: A total of 40 CD pts (20M, median age 34 yrs, range 18 70) fulfilled the inclusion criteria. Previous ileo-colonic resection was shown by 29/40 (72.5%) pts (median interval 10mths, range 3 300). CD localization involved the ileum in 37/40 (92%) CD (recurrence in 26/37) and also the upper GI in 4/37 (10%), while 3 pts showed no recurrence. SBCE showed marked interindividual variations in terms of gastric (median 29min, range 3 360) and small bowel transit times (valve: median 350min, range 240 433 or anastomosis in resected CD: median 231 min, range 61 466). SBCE did not visualize the entire small bowel in 9/40 (22.5%) pts (5/11 CD not resected, 4/29 resected pts). Upper GI lesions were detected by SBCE in 23/40 (57.5%) pts, known before SBCE in only 4/40 (10%) pts. In one pt, SBCE visualized an ulcerated jejunal stenosis requiring surgery not detected by SBFT and IC. In 1/40 (2.5%) pts, SBCE impact requiring surgery within a “cul de sac” of an ileo-ileal anastomosis was observed. Conclusions: Upper GI lesions may be detected by SBCE in a high proportion of CD pts, although their clinical relevance needs to be determined. Before SBCE, CD pts need a careful selection due to possible incomplete small bowel visualization and to the impact risk occurring also in the absence of stenosis.

P204 Small bowel capsule endoscopy in Crohn's disease: Detection of upper gastrointestinal lesions, impact rate, gastric and small bowel transit times in a tertiary referral center

P204 Small bowel capsule endoscopy in Crohn's disease: Detection of upper gastrointestinal lesions, impact rate, gastric and small bowel transit times in a tertiary referral center

Use of wireless motility capsule to determine gastric emptying and small intestinal transit times in critically ill trauma patients

PurposeThe purpose of this study is to use a novel wireless motility capsule to compare gastric emptying and small bowel transit times in critically ill trauma patients and healthy volunteers. Materials and MethodsWe evaluated gastric emptying, small bowel transit time, and total intestinal transit time in 8 critically ill trauma patients. These data were compared with those obtained in 87 healthy volunteers from a separate trial. Data were obtained with a motility capsule that wirelessly transmitted pH, pressure, and temperature to a recorder attached to each subject's abdomen. ResultsThe gastric emptying time was significantly longer in critically ill patients (median, 13.9; interquartile range [IQR], 6.6-48.3 hours) than in healthy volunteers (median, 3.0; IQR, 2.5-3.9 hours), P < .001. The small bowel transit time in critically ill patients was significantly longer than in healthy volunteers (median, 6.7 hours; IQR, 4.4-8.5 hours vs median, 3.8 hours; IQR, 3.1-4.7 hours), P = .01. Furthermore, the capsules passed after 10 (IQR, 8.5-13) days in the critical care group and 1.2 (IQR, 0.9-1.9) days in healthy volunteers (P < .001). ConclusionsBoth gastric emptying and small bowel transit were delayed in critically ill trauma patients.

Assessment of the Variation Associated with Repeated Measurement of Gastrointestinal Transit Times and Assessment of the Effect of Oral Ranitidine on Gastrointestinal Transit Times Using a Wireless Motility Capsule System in Dogs

This study aimed to evaluate the variation associated with repeated measurement of gastrointestinal (GI) transit times and the effect of oral ranitidine on GI transit times in healthy dogs using a wireless motility capsule (WMC) system. Eight privately owned healthy adult dogs were enrolled, and one developed diarrhea and was removed from the study. For the first 3 repetitions, each dog was fed a standard meal followed by oral administration of a WMC. For the 4th repetition, each dog was given ranitidine hydrochloride (75 mg PO every 12 hours) prior to and during assessment of GI transit times. Mean between-subject coefficients of variation for gastric emptying time (GET), small and large bowel transit time (SLBTT), and total transit time (TTT) were 26.9%, 32.3%, and 19.6%, respectively. Mean within-subject coefficients of variation for GET, SLBTT, and TTT were 9.3%, 19.6%, and 15.9%, respectively. Median GET, SLBTT, and TTT without ranitidine were 719, 1,636, and 2,735 minutes, respectively. Median GET, SLBTT, and TTT with ranitidine were 757, 1,227, and 2,083 minutes, respectively. No significant differences in GI transit times were found between any of the 4 repetitions. Under these experimental conditions, no significant effects of oral ranitidine on GI transit times were observed.

Use of Capsule Small Bowel Transit Time to Determine the Optimal Enteroscopy Approach.

BackgroundCapsule small bowel transit time (SBTT) is used to select the most effective enteroscopy approach when targeting capsule endoscopy (CE) findings. Aim of this study was to determine if capsule SBTT can be used to guide the choice of enteroscopy technique for reaching CE abnormalities.MethodsSingle center, retrospective study involving 60 patients. Data were abstracted from medical records of patients with abnormal CE who proceeded to enteroscopy which included push enteroscopy (PE) single balloon enteroscopy (SBE) and double balloon enteroscopy (DBE).ResultsNinety five findings were documented on CE with presumed identification of 56 (59%) of these abnormalities by enteroscopy. Majority were angioectasias on CE (42%) and enteroscopy (59%). Optimal cutoff values for selection of enteroscopy procedure were: 0-21% SBTT for PE (80% sensitivity, 74% specificity, 83% PPV); 0 - 36% SBTT for antegrade SBE (93% sensitivity, 40% specificity, 82% PPV); 0 - 57% SBTT for antegrade DBE (75% sensitivity, 80% specificity, 75% PPV); and 74 - 100% SBTT for retrograde DBE (88% sensitivity, 78% specificity, 78% PPV).ConclusionCapsule SBTT may be used to guide the selection of enteroscopy approach. PE, antegrade SBE, antegrade DBE and retrograde DBE are optimal when abnormalities on CE are seen at ≤ 21%, ≤ 36%, ≤ 57% and ≥ 74% SBTT respectively.

Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time

To investigate whether the small bowel transit time (SBTT) influences the diagnostic yield of capsule endoscopy (CE). Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed. SBTT and CE findings were recorded. A running mean for the SBTT was calculated and correlated to the diagnostic yield with a Spearman's correlation test. Subgroup analyses were performed for the various indications for the procedure. There was a positive correlation between the diagnostic yield and SBTT (Spearman's rho 0.58, P < 0.01). Positive correlations between diagnostic yield and SBTT were found for the indication obscure gastrointestinal bleeding (r = 0.54, P < 0.01), for polyposis and carcinoid combined (r = 0.56, P < 0.01) and for the other indications (r = 0.90, P <0.01), but not for suspected Crohn's disease (r = -0.40). The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time. This is true for all indications except for suspected Crohn's disease.