Opioid Use Is Not Associated with Incomplete Wireless Capsule Endoscopy for Inpatient or Outpatient Procedures

Abstract

Objective. Wireless capsule endoscopy (WCE) is commonly used to directly visualize the small bowel. Opioids have variably been linked with incomplete studies and prolonged transit times in heterogeneous cohorts. We aimed to investigate the effect of opioid use on WCE for inpatient and outpatient cohorts. Methods. We performed a retrospective review of patients receiving WCE at our institution from April 2010 to March 2013. Demographic data, medical history, and WCE details were collected. Transit times were compared by log-rank analysis. Multivariable logistic regression and Cox proportional hazard models were utilized. Results. We performed 314 outpatient and 280 inpatient WCE that met study criteria. In the outpatient cohort, gastric transit time (GTT) was not significantly different between opioid and nonopioid users. Completion rates were similar as well (88% and 87%, P = 0.91). In the inpatient cohort, GTT was significantly longer in patients receiving opioids than in patients not receiving opioids (44 versus 23 min, P = 0.04), but completion rates were similar (71% versus 75%, P = 0.31). Conclusion. Opioid use within 24 hours of WCE did not significantly affect completion rates for inpatients or outpatients. GTT was prolonged in inpatients receiving opioids but not in outpatients.

Physical activity during video capsule endoscopy correlates with shorter bowel transit time

“…We found that the use of narcotic medication was associated with incomplete VCE. This is in contrast to our previously published experience and has been found to be of variable significance in other studies 5 16 17 . Diabetes mellitus type 2 was also found to be significantly associated with incomplete VCE.…”

“…This is remarkable as BMI is not included as a clinical characteristic in most other series assessing completion rates and may be an uncontrolled factor affecting previously published results. To our knowledge, the series by Spada et al assessing bowel transit times during VCE in patients with Celiac disease and the work by our group assessing opioid use and VCE completion, are the only studies to include BMI as a variable 15 16 . Neither study reported a significant correlation but both are limited by a retrospective study design.…”

No significant difference in clinically relevant findings between Pillcam® SB3 and Pillcam® SB2 capsules in a United States veteran population

“…Diabetes has been shown to be a risk factor for poor colon preparations, though the effects of diabetes on CE preparation are poorly characterized[28]. Likewise, our study included a large percentage of current opioid users at 28.1%; however opioid use has not clearly been shown to be associated with altered exam completion rates or diagnostic findings[29,30].…”