Initial experience of real-time capsule endoscopy in monitoring progress of the videocapsule through the upper GI tract

Abstract

Background: Wireless capsule endoscopy (WCE) is one of the most important investigations for small bowel examination. Although newer-generation WCE is equipped with a real-time viewer, the role of this advancement in daily practice remains unknown. Objective: Our purpose was to determine the role of the real-time viewer for monitoring of the videoendoscope passage through the upper GI tract. Design: Case-control comparison. Setting: Single tertiary referral center. Patients: Forty-five consecutive patients who underwent capsule endoscopy in a 12-month period were studied. Twenty-seven patients received conventional WCE, whereas 18 patients were examined by real-time WCE. Passage into the small bowel was monitored with the real-time viewer in the second group of patients. Gastric transit time and the rate of complete small bowel examination were compared. Interventions: On-demand polyethylene glycol and erythromycin were prescribed according to the progress as viewed by the real-time monitor. Main Outcome Measurements: Small bowel examination completion rate and gastric transit time. Results: Small bowel examination was completed in 19 (70.4%) and 17 (94.4%) patients undergoing conventional and real-time WCE, respectively (P = .048). With the real-time monitoring and on-demand preparations, gastric passage time was significantly reduced (100 vs 59 minutes, P = .02). Limitations: Nonrandomized study. Conclusions: The use of the real-time viewer may help to secure the passage of the capsule endoscope into the small bowel and hence result in a higher rate of complete small bowel examination. © 2007 American Society for Gastrointestinal Endoscopy.