Age and Indication for Referral to Capsule Endoscopy Significantly Affect Small Bowel Transit Times: The Given Database

Abstract

The purpose of this study was to examine the effect of age and selected indications for capsule endoscopy on small bowel transit times. Data on 67 clinical studies (790 subjects with different gastrointestinal pathologies [49.5% males; mean age, 51.9 +/- 18.33 years; range, 18-91 years] and 87 healthy volunteers) were retrieved from the company (Given Imaging, Ltd.)-sponsored database. All subjects swallowed the PillCam SB Capsule after a 12-hr fast. The capsule reached the cecum in all 877 participants. Indications for referral for capsule endoscopy were as follows: 372 obscure gastrointestinal bleeding, 96 suspected Crohn's disease, 65 celiac disease, 54 irritable bowel syndrome, and 116 familial adenomatous polyposis, intestinal lymphoma, or ulcerative colitis. One group consisted of patients <40 years old (n = 235), and the other patients 40 years old (n = 555). The younger group, volunteers, and Crohn's disease patients had significantly shorter small bowel transit times than the others (P < 0.001). Gastric emptying indirectly influenced capsule transit time.

Age and Video Capsule Endoscopy in Obscure Gastrointestinal Bleeding: A Prospective Study on Hospitalized Patients

“…Papadopoulos et al investigated 120 consecutive outpatients who underwent VCE for suspected small bowel disease and concluded that: (a) aging did not affect the completion rate and (b) elderly people had more angiodysplasia and tumors than younger patients [11]. On the contrary, Fireman et al, who analyzed 790 subjects retrieved from the Given database, showed that age significantly influenced small bowel transit times [10]. However, in the former study, there was a significative difference between the age groups as for the indications of VCE, with one-third of [65-year-old patients performing VCE for obscure-overt GI bleeding compared to only 5 of the B65-year-old group.…”

“…Several risk factors for incomplete small bowel VCE examination have been identified [7][8][9]; among these, the influence of aging on VCE procedures is poorly known. Age was either indicated as significantly affecting small bowel transit times during VCE examination in a retrospective study [10] or having no effect in a more recent prospective study [11]. Furthermore, the effect of aging on the performance of VCE in obscure gastrointestinal bleeding (OGIB) has never been prospectively assessed.…”

The Bitter Taste Receptor Agonist Quinine Reduces Calorie Intake and Increases the Postprandial Release of Cholecystokinin in Healthy Subjects

“…The capsule was acid-resistant in order to facilitate the release of bitter compound or placebo into the duodenum. Considering the available data on gastric emptying time after an overnight fast, 20,21 we chose a 60-minute interval between capsule administration and the ad libitum test (see below). During the experiment, a questionnaire was administered to assess GI sensations and plasma samples were obtained in order to evaluate GI peptide levels (Fig.…”

Examining Small Intestinal Transit Time as a Function of Age: Is There Evidence to Support Age-Dependent Differences among Children?

“…Literature data pertaining to capsule endoscopy are primarily focused toward disease diagnosis with information regarding GI transit commonly reported as a secondary outcome. Such studies typically include patients with known or suspected GI disease for indications such as obscure GI bleeding, undiagnosed abdominal pain, suspected Crohn's disease, ulcerative colitis, celiac disease, and small bowel tumors (Fireman et al, 2007). Based on 11 capsule endoscopy studies (Fireman et al, 2005(Fireman et al, , 2007Velayos Jiménez et al, 2005;Ge et al, 2007;Tokuhara et al, 2010;Nuutinen et al, 2011;Robinson et al, 2011;Westerhof et al, 2012;Yazici et al, 2012;OikawaKawamoto et al, 2013;Ou et al, 2014), which provided information on 16 unique subject groups with mean ages ranging from 2.9 to 64 years, a meta-regression was performed using a similar methodology as described previously.…”