Influence of demographic and clinical features of the patient on transit times and impact the on the diagnostic yield of capsule endoscopy

Valenzuela, Juan Egea; Martínez, Ana Sánchez; Marín, Ana Victoria García; Parras, Fernando Alberca de Las

doi:10.17235/reed.2019.5971/2018

Cited by 6 publications

(9 citation statements)

References 23 publications

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“…[4][5][6][7] Recent investigation have hypothesized that longer SBTT could be a factor associated with higher rates of lesion detection in SBB. [8][9][10] In our cohort, in univariate analysis we found in accordance to previous studies that older patients, male gender, and with chronic comorbidities such as hypertension, diabetes, CKD and HF presented more frequently with P2 lesions in SBCE. [4][5][6][7] Moreover, in our study, patients with P2 lesions in SBCE presented longer SBTT, suggesting that slower passage of the capsule in the small bowel allows for a better inspection of the small bowel mucosa and it is associated with higher diagnostic yield for significant lesions.…”

Section: Discussionsupporting

confidence: 89%

“…Despite Egea-Valenzuela J. et al having found a positive correlation between prolonged SBTT and higher diagnostic yield of SBCE, this study included all types of indication for SBCE and not only SBB. 9 Oppositely, Velayos Jiménez B et al found no differences in SBTT with regard to age, gender or body mass index, despite this study being limited by sample size (n=89)…”

Section: Discussionmentioning

confidence: 58%

“…[4][5][6][7] Recently, small-bowel transit time (SBTT) was pointed as a factor associated with the diagnostic yield of significant lesions in SBB. [8][9][10] Incomplete SBCE evaluation may impair the diagnostic yield and factors such as hospitalization, previous surgery or radiation, diabetes mellitus and very old age have been identified as potential risk factors. The combined strategy of checking the position of SBCE with real time viewer and the selective administration of prokinetics has been adopted to overcome this limitation.…”

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confidence: 99%

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Small Bowel Transit Time in Capsule Endoscopy: a determinant factor for the diagnosis of small bowel bleeding

et al. 2021

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BackgroundSmall bowel capsule endoscopy (SBCE) is the gold standard in the study of small bowel bleeding (SBB). Recent studies suggested that longer small bowel transit times (SBTT) may be associated with higher diagnostic yield of SBCE.. AimThe aim of the study is to investigate if longer SBTT is a predictive factor of positive findings on SBCE in a population that performed SBCE due to suspected SBB. MethodsRetrospective single-center study, including consecutive SBCE between May 2012 and May 2019 due to suspected SBB. Positive SBCE was considered in the presence of lesions with high bleeding potential, such as ulcers, angioectasias and tumors (P2 lesions, according to the Saurin classification). ResultsWe included 372 patients, 65.9 % female, with median age 67 (IQR: 19-97) years.We observed that patients with P2 lesions (n=131; 35.2 %) in SBCE presented longer SBTT (p=0.01), were older (p<0.001), more frequently male (p=0.019), suffered more frequently from arterial hypertension (p=0.011), diabetes (p=0.042), chronic kidney disease (p=0.003) and heart failure (p=0.001). In logistic analysis, the significant predictive factors for the presence of P2 lesions were age (OR1.027;IC 95 % 1.009-1.045;p=0.004), SBTT (OR1.002; IC95 % 1.001-1.005; p=0.029) and male gender (OR 1.588;IC95 %1.001-2.534;p=0.049). ConclusionsPatients with longer SBTT presented higher rates of lesions with high bleeding potential (P2). SBTT along with previous well defined factors-age and male gender were the only independent predictor factors of the presence of P2 lesions. These findings may suggest that slower passage of the capsule in the small bowel may allow a better diagnostic yield for significant lesions.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 58%

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confidence: 99%

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Small Bowel Transit Time in Capsule Endoscopy: a determinant factor for the diagnosis of small bowel bleeding

et al. 2021

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“…When the 2013 Tokyo guidelines were proposed, the sensitivity (93% vs 91.8%) and the specificity (77.9% vs 77.7%) for the diagnosis of AC were similar for 2 different cutoff points of deranged LFT results (more than the upper limit vs 1.5 times the upper limit of normal, respectively). 2 However, a significantly higher number of patients with acute cholecystitis were inappropriately included as having acute cholangitis with diagnostic cutoff points of the upper limit of LFT results compared with 1.5 times the elevation of LFT results (9.1% vs 5.1%).…”

mentioning

confidence: 99%

“…The higher completion rate in the "diving group" could be simply explained by a shorter, although nonsignificant, small-bowel transit time, which could ultimately compromise the diagnostic yield. 2 This trial is an important step forward, bringing to debate several aspects that remain unsettled in SBCE: (1) the lack of consensus about the best preprocedural preparation, 3,4 (2) the promising role of intraprocedural preparation, 5 with water and lower quantities of isosmotic or hyperosmotic purgatives (important not only to evaluate safety and efficacy but also to perform dose-range finding studies); and (3) the lack of validated, reproducible, and easy cleansing scoring scales, 6 as recently highlighted, 7 which are critical to evaluate small-bowel preparation protocols.…”

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confidence: 99%

BILE criteria: Is it too early, or a stage is set?

Jena

Singh

2021

Gastrointestinal Endoscopy

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eliminate the need for insulin therapy in most patients with type 2 diabetes (T2D) with adequate b-cell capacity while improving glucose regulation and metabolic health in all patients. Related research is limited, and the mechanisms of DMR in treating patients with T2D are unclear. Therefore, we propose the potential therapeutic mechanism of DMR from the aspect of the enteroendocrine role of the duodenum through this research, which may promote the future clinical application of DMR before long-term drug use or to aid drug therapy.GLP-1RA treats T2D accompanied with weight loss and improved blood lipid and blood pressure by stimulating insulin secretion, inhibiting glucagon secretion, increasing the glucose intake of muscle and adipose tissue, and inhibiting hepatic glucose production, gastric emptying, and appetite. GLP-1R is distributed in islet cells, hepatocyte, and adipocyte, among others. On the duodenal mucosa, there is a type of incretin producing enteroendocrine cell, GLP-1-producing L-cells. Physiologically, GLP-1 is released into the bloodstream when dietary carbohydrate enters the duodenum at rates that exceed the absorptive capacity of the proximal small intestine. DMR can replace the epithelium of the duodenum, and L-cells can regenerate after appropriate destruction.It is reasonable to think that the regeneration of GLP-1-producing L-cells may be the most dominant mechanism of DMR treating T2D, and further abnormal L-cells may be involved in the mechanism of T2D. That is also why GLP-1RA works and GLP-1 plasma levels are lower in T2D patients. Furthermore, DMR supported by mature technology will be more efficient, can even replace the low required dose of GLP-1, and will be more effective combined with GLP-1RA, inasmuch as new and lively Lcells can produce more GLP-1 than before, which is supported by this research. 1

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GI factors, potential to predict prostate motion during radiotherapy; a scoping review

Alexander

Oelfke

McNair

et al. 2023

Clinical and Translational Radiation Oncology

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Influence of demographic and clinical features of the patient on transit times and impact the on the diagnostic yield of capsule endoscopy

Cited by 6 publications

References 23 publications

Small Bowel Transit Time in Capsule Endoscopy: a determinant factor for the diagnosis of small bowel bleeding

Small Bowel Transit Time in Capsule Endoscopy: a determinant factor for the diagnosis of small bowel bleeding

BILE criteria: Is it too early, or a stage is set?

GI factors, potential to predict prostate motion during radiotherapy; a scoping review

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