Su1263 DOES INDICATION HAVE AN ASSOCIATION WITH SMALL BOWEL CAPSULE TRANSIT TIME AND DIAGNOSTIC YIELD?

Abstract

Introduction: There are clear European Society of Gastrointestinal Endoscopy (ESGE) guidelines for the use of Small Bowel Capsule Endoscopy (SBCE), the use of bowel prep is routinely recommended but there are queries about its overall efficacy. The diagnostic yield of SBCE depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. Previous studies have suggested that longer small bowel capsule transit times (SBCTT) can increases diagnostic yield. The use of pro-motility agents including bowel prep can shorten SBCTT. Other factors that influence SBCTT are not fully understood. Aims/ Background: The aim of the study is to evaluate whether indication for SBCE affects SBCTT and diagnostic yield Method: We collected data from all capsule endoscopies performed in Tallaght Hospital, Ireland from 2015 to 2016 inclusively. We excluded capsules with incomplete reports. SBCTT and diagnostic yield was compared according to each referral group. Parametric data was compared using student t-test and a p value of <0.05 was considered significant. Results: 649 SBCE's with complete data sets were identified, 313 (48%) males, and mean age 52.9 (16-93). Indication for SBCE were; IBD diagnosis and assessment 233 (36%), Coeliac Disease diagnosis and assessment 16 (2%), obscure occult GI bleeding including anaemia 330 (51%), obscure overt GI bleeding 22 (3%), lesion assessment 9 (1%), abnormal radiology 9 (1%), and others 30 (5%). In our department, bowel prep is not routinely used for SBCE. Overall mean SBCTT was 241 (21-717) minutes and overall 288 (44%) patients had a positive SBCE. When comparing indications with SBCTT, there were no significant difference in SBCTT according to referral groups except for coeliac disease which was significantly longer (296v240, p< 0.01). Mean overall SBCTT was significantly longer for positive studies, (256v229, pZ0.006 95% CI 12.01-43.4) and within the IBD group (222.3v256.6 p<0.02) but not for other indications. Conclusions: Our study supportsthat longer SBCTT is positively associated with diagnostic yield. Indication for SBCE can affect SBCTT. This study brings into question the regular use of prep pre-SBCE which can reduce transit times and suggests that only selective use according to indication should be considered.