The Relationship between Physical Activity Level and Completion Rate of Small Bowel Examination in Patients Undergoing Capsule Endoscopy

Abstract

Objective Capsule endoscopy (CE) allows direct examination of the small bowel in a safe, noninvasive and well-tolerated manner. Nonetheless, experience indicates failure to reach the cecum in 20-30% of patients within the 8 hour battery life. Attempts to improve the completion rate (CR) as defined by reaching the cecum have been unsuccessful. This study was to investigate the relationship between patients' physical activity and CR. Methods Between January 2009 and January 2010, 76 patients (44 men, 32 women; median age 64.5 yr) underwent CE for the diagnosis of small intestinal disorders. Indications for CE were obscure gastrointestinal bleeding/anemia (62 cases), others (14 cases). Patients were divided into an outpatient group (n=23), mild bed rest group (n=35) and strict bed rest group (n=18). Results For all patients, the average gastric transit time was 65.5 minutes, small bowel transit time was 301.4 minutes and the CR was 86.8%. However, the CR was 100% (23/23) in the outpatient group, an 85.7% (30/35) in the mild bed rest group, and 72.2% (13/18) in the strict bed rest group. The CR increased with physical activity of patients by Cochran-Armitage Trend Test (p=0.009). In multivariate logistic regression analyses, low physical activity was a significant risk factor for failure to reach the cecum during CE examination; adjusted OR: 3.39, 95% CI: 1.01-11.42 (p=0.048). Conclusion Our observations suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. Further, for CE, inconvenient bowel preparations like the use of polyethylene glycol may be avoided.

Video capsule endoscopy completion and total transit times are similar with oral or endoscopic delivery

“…Due to this size, we were able to avoid the confounding factor of hospitalization status that limited all previous studies. We were unable to assess the mobility of the hospitalized patients, which may have affected transit times 14 . However, there were only 2 patients in the endoscopically placed group who were in the intensive care unit and there was no mention of strict bed rest orders for the other patients.…”

Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices

“…There have been minimal data presented on the rate of completed studies and on the diagnostic success of VCE carried out in this setting. Study completion is a particular concern as cardiac monitoring limits patient movement and immobility has been previously linked with incomplete VCE studies . Only two series have reported completion rates and they had divergent results when compared to the average VCE completion rate of 83.5% .…”

“…Study completion is a particular concern as cardiac monitoring limits patient movement and immobility has been previously linked with incomplete VCE studies. 11 Only two series have reported completion rates and they had divergent results when compared to the average VCE completion rate of 83.5%. 9,12,13 To our knowledge, only one series of 20 patients describes the diagnostic yield of the procedures.…”

A Trial of the Use of Patency Capsules in Combination with Overnight Capsule Endoscopy

“…Hospitalization has been pointed out as a risk factor for incomplete small bowel examinations [23,24,25]. Shibuya et al [26] suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. In contrast, two reports suggest that a prolonged small bowel transit time during CE may be associated with a higher diagnostic yield [27,28].…”