Validation of SmartPill<sup>®</sup> wireless motility capsule for gastrointestinal transit time: Intra‐subject variability, software accuracy and comparison with video capsule endoscopy

Tartera, Hetzel O. Diaz; Webb, Dominic-Luc; Al-Saffar, Anas; Halim, Abdul; Lindberg, Greger; Sangfelt, Per; Hellström, Per M.

doi:10.1111/nmo.13107

Cited by 60 publications

(48 citation statements)

References 37 publications

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“…The intra‐individual COV for GE measured with scintigraphy in this study is lower than that measured with the SmartPill capsule in 10 healthy male subjects, ie, 40% at 2 weeks and 24% at 4 weeks . The intra‐individual COV for GE measured with the SmartPill capsule in patients is unknown.…”

Section: Discussioncontrasting

confidence: 58%

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

Desai

O’Connor

Neja

et al. 2018

Neurogastroenterology Motil

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Section: Discussioncontrasting

confidence: 58%

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

Desai

O’Connor

Neja

et al. 2018

Neurogastroenterology Motil

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“…However, this contribution is likely less important as the highest component of whole gut transit time is colonic. 26 It is currently unclear which technologies for assessing motility are superior, as there is no clear gold standard. However, radiopaque marker testing has a long track record of use, and is a simple, relatively low-cost test to administer.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Slow Transit Constipation in Patients With Gastroparesis

Zikos

Kamal

Neshatian

et al. 2019

J Neurogastroenterol Motil

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Background/Aims Current evidence suggests the presence of motility or functional abnormalities in one area of the gastrointestinal tract increases the likelihood of abnormalities in others. However, the relationship of gastroparesis to chronic constipation (slow transit constipation and dyssynergic defecation) has been incompletely evaluated. Methods We retrospectively reviewed the records of all patients with chronic dyspeptic symptoms and constipation who underwent both a solid gastric emptying scintigraphy and a high-resolution anorectal manometry at our institution since January 2012. When available, X-ray defecography and radiopaque marker colonic transit studies were also reviewed. Based on the gastric emptying results, patients were classified as gastroparesis or dyspepsia with normal gastric emptying (control group). Differences in anorectal and colonic findings were then compared between groups. Results Two hundred and six patients met the inclusion criteria. Patients with gastroparesis had higher prevalence of slow transit constipation by radiopaque marker study compared to those with normal emptying (64.7% vs 28.1%, P = 0.013). Additionally, patients with gastroparesis had higher rates of rectocele (88.9% vs 60.0%, P = 0.008) and intussusception (44.4% vs 12.0%, P = 0.001) compared to patients with normal emptying. There was no difference in the rate of dyssynergic defecation between those with gastroparesis vs normal emptying (41.1% vs 42.1%, P = 0.880), and no differences in anorectal manometry findings. Conclusions Patients with gastroparesis had a higher rate of slow transit constipation, but equal rates of dyssynergic defecation compared to patients with normal gastric emptying. These findings argue for investigation of possible delayed colonic transit in patients with gastroparesis and vice versa.

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“…Colonic transit can also be measured using other modalities, including colonic scintigraphy, 52 where patients are given a radioisotope‐labelled meal and timed measurements of residual radioactivity are made to calculate transit, and wireless motility capsule, 53 which uses changes in pH along the gastrointestinal tract to determine transit time. In practice, these investigations are used in a limited number of specialist centres, and are not routine in investigating patients with constipation.…”

Section: Clinical Assessment and Investigationmentioning

confidence: 99%

“…Retention of five or more markers is indicative of slow transit, but care must be taken not to overinterpret the result, with a recent study showing that the number of retained markers does not correlate with symptom severity or quality of life in CIC. 51 Colonic transit can also be measured using other modalities, including colonic scintigraphy, 52 where patients are given a radioisotope-labelled meal and timed measurements of residual radioactivity are made to calculate transit, and wireless motility capsule, 53 which uses changes in pH along the gastrointestinal tract to determine transit time. In practice, these investigations are used in a limited number of specialist centres, and are not routine in investigating patients with constipation.…”

Section: Slow Transit Constipationmentioning

confidence: 99%

Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management

Black

Ford

2018

Medical Journal of Australia

134

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Chronic idiopathic constipation (CIC) is one of the most common gastrointestinal disorders, with a global prevalence of 14%. It is commoner in women and its prevalence increases with age. There are three subtypes of CIC: dyssynergic defaecation, slow transit constipation and normal transit constipation, which is the most common subtype. Clinical assessment of the patient with constipation requires careful history taking, in order to identify any red flag symptoms that would necessitate further investigation with colonoscopy to exclude colorectal malignancy. Screening for hypercalcaemia, hypothyroidism and coeliac disease with appropriate blood tests should be considered. A digital rectal examination should be performed to assess for evidence of dyssynergic defaecation. If this is suspected, further investigation with high resolution anorectal manometry should be undertaken. Anorectal biofeedback can be offered to patients with dyssynergic defaecation as a means of correcting the associated impairment of pelvic floor, abdominal wall and rectal functioning. Lifestyle modifications, such as increasing dietary fibre, are the first step in managing other causes of CIC. If patients do not respond to these simple changes, then treatment with osmotic and stimulant laxatives should be trialled. Patients not responding to traditional laxatives should be offered treatment with prosecretory agents such as lubiprostone, linaclotide and plecanatide, or the 5-HT4 receptor agonist prucalopride, where available. If there is no response to pharmacological treatment, surgical intervention can be considered, but it is only suitable for a carefully selected subset of patients with proven slow transit constipation.

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Validation of SmartPill^® wireless motility capsule for gastrointestinal transit time: Intra‐subject variability, software accuracy and comparison with video capsule endoscopy

Abstract: GET, SBTT, CTT and WGTT obtained by WMC are commensurate with literature values, including by other methods. Visually and software derived transit times have strongest correlations for CTT and WGTT. WMC yields longer GET and SBTT than VCE, perhaps due to meal related effects on motility.

Cited by 60 publications

References 37 publications

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

High Prevalence of Slow Transit Constipation in Patients With Gastroparesis

Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management

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Validation of SmartPill® wireless motility capsule for gastrointestinal transit time: Intra‐subject variability, software accuracy and comparison with video capsule endoscopy

Abstract: GET, SBTT, CTT and WGTT obtained by WMC are commensurate with literature values, including by other methods. Visually and software derived transit times have strongest correlations for CTT and WGTT. WMC yields longer GET and SBTT than VCE, perhaps due to meal related effects on motility.

Cited by 60 publications

References 37 publications

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

Reproducibility of gastric emptying assessed with scintigraphy in patients with upper GI symptoms

High Prevalence of Slow Transit Constipation in Patients With Gastroparesis

Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management

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Product

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About

Validation of SmartPill^® wireless motility capsule for gastrointestinal transit time: Intra‐subject variability, software accuracy and comparison with video capsule endoscopy