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Published in: BMC Gastroenterology 1/2007

Open Access 01-12-2007 | Research article

Findings in patients with chronic intestinal dysmotility investigated by capsule endoscopy

Authors: Charlotte M Hoog, Greger Lindberg, Urban Sjoqvist

Published in: BMC Gastroenterology | Issue 1/2007

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Abstract

Background

Capsule endoscopy (CE) is a unique tool to visualize the mucosa of the small intestine. Chronic intestinal dysmotility (CID) is a group of rare disorders of gastrointestinal motility that often are complicated by bacterial overgrowth. The aim of this study was to determine the prevalence of small bowel mucosal abnormalities in patients with CID. We also studied the usefulness of CE in the diagnosis of intestinal dysmotility.

Methods

We conducted a prospective study using CE in 18 patients; six with myopathic, 11 with neuropathic and one with indeterminate CID. A control group was used for comparison of small bowel transit.

Results

Mucosal breaks (erosions and ulcerations) were found in 16/18 (89%) patients. The capsule reached the caecum in 11/18 (61%) patients with a median transit time of 346 minutes. In the control group the capsule reached the caecum in 29/36 (81%) cases with a median transit time of 241 minutes. The difference in transit time was not significant (p = 0.061) in this material. The capsule was retained in the stomach in 3/18 patients. None of the patients developed symptoms or signs of mechanical obstruction.

Conclusion

A high frequency of mucosal breaks and signs of motility disturbances were seen in CID patients. CE is feasible for the examination of small bowel mucosa in patients with CID. The relevance of observed mucosal abnormalities in CID remains uncertain.
Appendix
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Literature
1.
go back to reference Rosa-E-Silva L, Gerson L, Davila M, Triadafilopoulos G: Clinical, radiologic, and manometric characteristics of chronic intestinal dysmotility: the Stanford experience. Clin Gastroenterol Hepatol. 2006, 4: 866-873. 10.1016/j.cgh.2006.05.001.CrossRefPubMed Rosa-E-Silva L, Gerson L, Davila M, Triadafilopoulos G: Clinical, radiologic, and manometric characteristics of chronic intestinal dysmotility: the Stanford experience. Clin Gastroenterol Hepatol. 2006, 4: 866-873. 10.1016/j.cgh.2006.05.001.CrossRefPubMed
2.
go back to reference Christensen J, Dent J, Malagelada JR, Wingate DL: Pseudo-obstruction. Gastroenterol Intl. 1990, 3: 107-119. Christensen J, Dent J, Malagelada JR, Wingate DL: Pseudo-obstruction. Gastroenterol Intl. 1990, 3: 107-119.
3.
4.
go back to reference Wingate D, Hongo M, Kellow J, Lindberg G, Smout A: Disorders of gastrointestinal motility: towards a new classification. J Gastroenterol Hepatol. 2002, 17 (Suppl): S1-14. 10.1046/j.1440-1746.17.s1.7.x.CrossRefPubMed Wingate D, Hongo M, Kellow J, Lindberg G, Smout A: Disorders of gastrointestinal motility: towards a new classification. J Gastroenterol Hepatol. 2002, 17 (Suppl): S1-14. 10.1046/j.1440-1746.17.s1.7.x.CrossRefPubMed
5.
go back to reference Hirano I, Pandolfino J: Chronic intestinal pseudo-obstruction. Dig Dis. 2000, 18: 83-92. 10.1159/000016969.CrossRefPubMed Hirano I, Pandolfino J: Chronic intestinal pseudo-obstruction. Dig Dis. 2000, 18: 83-92. 10.1159/000016969.CrossRefPubMed
6.
go back to reference Stanghellini V, Cogliandro RF, De Giorgio R, Giovanni B, Morselli-Labate AM, Cogliandro L, Corinaldesi R: Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroenterol Hepatol. 2005, 3: 449-458. 10.1016/S1542-3565(04)00675-5.CrossRefPubMed Stanghellini V, Cogliandro RF, De Giorgio R, Giovanni B, Morselli-Labate AM, Cogliandro L, Corinaldesi R: Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroenterol Hepatol. 2005, 3: 449-458. 10.1016/S1542-3565(04)00675-5.CrossRefPubMed
7.
go back to reference Iddan G, Meron G, Glukhovsky A, Swain P: Wireless capsule endoscopy. Nature. 2000, 405: 417-10.1038/35013140.CrossRefPubMed Iddan G, Meron G, Glukhovsky A, Swain P: Wireless capsule endoscopy. Nature. 2000, 405: 417-10.1038/35013140.CrossRefPubMed
8.
go back to reference Swain P, Adler D, Enns R: Capsule endoscopy in obscure intestinal bleeding. Endoscopy. 2005, 37: 655-659. 10.1055/s-2005-870253.CrossRefPubMed Swain P, Adler D, Enns R: Capsule endoscopy in obscure intestinal bleeding. Endoscopy. 2005, 37: 655-659. 10.1055/s-2005-870253.CrossRefPubMed
9.
go back to reference Barkin JS, O'Loughlin C: Capsule endoscopy contraindications: Complications and how to avoid their occurrence. Gastrointest Endoscopy Clin N Am. 2004, 14: 61-65. 10.1016/j.giec.2003.10.016.CrossRef Barkin JS, O'Loughlin C: Capsule endoscopy contraindications: Complications and how to avoid their occurrence. Gastrointest Endoscopy Clin N Am. 2004, 14: 61-65. 10.1016/j.giec.2003.10.016.CrossRef
10.
go back to reference Storch I, Barkin JS: Contraindications to capsule endoscopy: Do they still exist?. Gastrointest Endosc Clin N Am. 2006, 16: 329-36. 10.1016/j.giec.2006.01.017.CrossRefPubMed Storch I, Barkin JS: Contraindications to capsule endoscopy: Do they still exist?. Gastrointest Endosc Clin N Am. 2006, 16: 329-36. 10.1016/j.giec.2006.01.017.CrossRefPubMed
11.
go back to reference Ohlsson B, Fork FT, Veress B, Toth E: Coexistent chronic idiopathic pseudo-obstruction and inflammatory bowel disease. Gut. 2005, 54: 729-730. 10.1136/gut.2004.058826.CrossRefPubMedPubMedCentral Ohlsson B, Fork FT, Veress B, Toth E: Coexistent chronic idiopathic pseudo-obstruction and inflammatory bowel disease. Gut. 2005, 54: 729-730. 10.1136/gut.2004.058826.CrossRefPubMedPubMedCentral
12.
go back to reference Carlo JT, DeMarco D, Smith BA, Livingstone S, Wiser K, Kuhn JA, Lamont JP: The utility of capsule endoscopy and its role for diagnosing pathology in the gastrointestinal tract. Am J Surg. 2005, 190: 886-890. 10.1016/j.amjsurg.2005.08.015.CrossRefPubMed Carlo JT, DeMarco D, Smith BA, Livingstone S, Wiser K, Kuhn JA, Lamont JP: The utility of capsule endoscopy and its role for diagnosing pathology in the gastrointestinal tract. Am J Surg. 2005, 190: 886-890. 10.1016/j.amjsurg.2005.08.015.CrossRefPubMed
13.
go back to reference Cave D, Legnani P, De Franchis R, Lewis BS: ICCE consensus for capsule retention. Endoscopy. 2005, 37: 1065-1067. 10.1055/s-2005-870264.CrossRefPubMed Cave D, Legnani P, De Franchis R, Lewis BS: ICCE consensus for capsule retention. Endoscopy. 2005, 37: 1065-1067. 10.1055/s-2005-870264.CrossRefPubMed
14.
go back to reference Selby W: Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc. 2005, 61: 80-85. 10.1016/S0016-5107(04)02462-9.CrossRefPubMed Selby W: Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc. 2005, 61: 80-85. 10.1016/S0016-5107(04)02462-9.CrossRefPubMed
15.
go back to reference Lai L, Wong G, Chow D, Lau J, Sung J, Leung W: Inter-observer variations on interpretation of capsule endoscopies. Eur J Gastroenterol Hepatol. 2006, 18: 283-286. 10.1097/00042737-200603000-00009.CrossRefPubMed Lai L, Wong G, Chow D, Lau J, Sung J, Leung W: Inter-observer variations on interpretation of capsule endoscopies. Eur J Gastroenterol Hepatol. 2006, 18: 283-286. 10.1097/00042737-200603000-00009.CrossRefPubMed
16.
go back to reference Ben-Soussan E, Savoye G, Antonietti M, Ramirez S, Lerebours E, Ducrotte P: Factors that affect gastric passage of video capsule. Gastrointest Endosc. 2005, 62: 785-790. 10.1016/j.gie.2005.07.040.CrossRefPubMed Ben-Soussan E, Savoye G, Antonietti M, Ramirez S, Lerebours E, Ducrotte P: Factors that affect gastric passage of video capsule. Gastrointest Endosc. 2005, 62: 785-790. 10.1016/j.gie.2005.07.040.CrossRefPubMed
18.
go back to reference Dai N, Gubler C, Hengstler P, Meyenberger C, Bauerfeind P: Improved capsule endoscopy after bowel preparation. Gastrointest Endosc. 2005, 61: 28-31. 10.1016/S0016-5107(04)02444-7.CrossRefPubMed Dai N, Gubler C, Hengstler P, Meyenberger C, Bauerfeind P: Improved capsule endoscopy after bowel preparation. Gastrointest Endosc. 2005, 61: 28-31. 10.1016/S0016-5107(04)02444-7.CrossRefPubMed
19.
go back to reference Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R: Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: Report of 100 consecutive cases. Gastroenterology. 2004, 126: 643-53. 10.1053/j.gastro.2003.11.057.CrossRefPubMed Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R: Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: Report of 100 consecutive cases. Gastroenterology. 2004, 126: 643-53. 10.1053/j.gastro.2003.11.057.CrossRefPubMed
20.
go back to reference Goldstein JL, Eisen GM, Lewis B, Gralnek IM, Zlotnick S, Fort JG: Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazol, and placebo. Clin Gastroenterol Hepatol. 2005, 3: 133-141. 10.1016/S1542-3565(04)00619-6.CrossRefPubMed Goldstein JL, Eisen GM, Lewis B, Gralnek IM, Zlotnick S, Fort JG: Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazol, and placebo. Clin Gastroenterol Hepatol. 2005, 3: 133-141. 10.1016/S1542-3565(04)00619-6.CrossRefPubMed
21.
go back to reference Pennazio M: Small-intestinal pathology on capsule endoscopy: inflammatory lesions. Endoscopy. 2005, 37: 769-775. 10.1055/s-2005-870178.CrossRefPubMed Pennazio M: Small-intestinal pathology on capsule endoscopy: inflammatory lesions. Endoscopy. 2005, 37: 769-775. 10.1055/s-2005-870178.CrossRefPubMed
22.
go back to reference Fortun PJ, Hawkey CJ: Nonsteroidal anti-inflammatory drugs and the small intestine. Curr Opin Gastroenterol. 2005, 21: 169-175. 10.1097/01.mog.0000153314.51198.58.CrossRefPubMed Fortun PJ, Hawkey CJ: Nonsteroidal anti-inflammatory drugs and the small intestine. Curr Opin Gastroenterol. 2005, 21: 169-175. 10.1097/01.mog.0000153314.51198.58.CrossRefPubMed
23.
go back to reference Chutkan R, Toubia N: Effect of nonsteroidal anti-inflammatory drugs on the gastrointestinal tract: Diagnosis by wireless capsule endoscopy. Gastrointest Endosc Clin N Am. 2004, 14: 67-86. 10.1016/j.giec.2003.10.009.CrossRefPubMed Chutkan R, Toubia N: Effect of nonsteroidal anti-inflammatory drugs on the gastrointestinal tract: Diagnosis by wireless capsule endoscopy. Gastrointest Endosc Clin N Am. 2004, 14: 67-86. 10.1016/j.giec.2003.10.009.CrossRefPubMed
24.
go back to reference Panganamamula KV, Parkman HP: Chronic intestinal pseudo-obstruction. Curr Treat Options Gastroenterol. 2005, 8: 3-11. 10.1007/s11938-005-0046-4.CrossRefPubMed Panganamamula KV, Parkman HP: Chronic intestinal pseudo-obstruction. Curr Treat Options Gastroenterol. 2005, 8: 3-11. 10.1007/s11938-005-0046-4.CrossRefPubMed
25.
go back to reference Barkin JS, Friedman S: Wireless capsule endoscopy requiring surgical intervention. The world's experience. Am J Gastroenterol. 2002, 97: A-83. 10.1016/S0002-9270(02)05390-X.CrossRef Barkin JS, Friedman S: Wireless capsule endoscopy requiring surgical intervention. The world's experience. Am J Gastroenterol. 2002, 97: A-83. 10.1016/S0002-9270(02)05390-X.CrossRef
26.
go back to reference Cheifetz AS, Lewis B: Capsule endoscopy retention: Is it a complication?. J Clin Gastroenterol. 2006, 40: 688-691. 10.1097/00004836-200609000-00005.CrossRefPubMed Cheifetz AS, Lewis B: Capsule endoscopy retention: Is it a complication?. J Clin Gastroenterol. 2006, 40: 688-691. 10.1097/00004836-200609000-00005.CrossRefPubMed
27.
go back to reference Rondonotti E, Herrerias JM, Pennazio M, Caunedo A, Mascarenhas-Saraiva M, De Franchis R: Complications, limitations, and failures of capsule enodscopy: a review of 733 cases. Gastrointest Endosc. 2005, 62: 852-856. 10.1016/j.gie.2005.05.002.CrossRef Rondonotti E, Herrerias JM, Pennazio M, Caunedo A, Mascarenhas-Saraiva M, De Franchis R: Complications, limitations, and failures of capsule enodscopy: a review of 733 cases. Gastrointest Endosc. 2005, 62: 852-856. 10.1016/j.gie.2005.05.002.CrossRef
28.
go back to reference Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, Lewis BS: The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease. Am J Gastroenterol. 2006, 101: 2218-2222. 10.1111/j.1572-0241.2006.00761.x.CrossRefPubMed Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, Lewis BS: The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease. Am J Gastroenterol. 2006, 101: 2218-2222. 10.1111/j.1572-0241.2006.00761.x.CrossRefPubMed
29.
go back to reference Baichi MM, Arifuddin RM, Mantry PS: What have we learned from 5 cases of permanent capsule retention. Gastroinst Endosc. 2006, 64: 283-287. 10.1016/j.gie.2006.02.036.CrossRef Baichi MM, Arifuddin RM, Mantry PS: What have we learned from 5 cases of permanent capsule retention. Gastroinst Endosc. 2006, 64: 283-287. 10.1016/j.gie.2006.02.036.CrossRef
30.
go back to reference Sears DM, Avots-Avontins A, Culp K, Gavin MW: Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc. 2004, 60: 822-827. 10.1016/S0016-5107(04)02019-X.CrossRefPubMed Sears DM, Avots-Avontins A, Culp K, Gavin MW: Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc. 2004, 60: 822-827. 10.1016/S0016-5107(04)02019-X.CrossRefPubMed
31.
go back to reference Mow WS, Lo SK, Targan SR, Dubinsky MC, Treyzon L, Abreu-Martin MT: Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hep. 2004, 2: 31-40. 10.1016/S1542-3565(03)00289-1.CrossRef Mow WS, Lo SK, Targan SR, Dubinsky MC, Treyzon L, Abreu-Martin MT: Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hep. 2004, 2: 31-40. 10.1016/S1542-3565(03)00289-1.CrossRef
32.
go back to reference Legnani P, Kornbluth A: Video capsule endoscopy in inflammatory bowel disease in 2005. Curr Opin Gastroenterol. 2005, 21: 438-442.PubMed Legnani P, Kornbluth A: Video capsule endoscopy in inflammatory bowel disease in 2005. Curr Opin Gastroenterol. 2005, 21: 438-442.PubMed
Metadata
Title
Findings in patients with chronic intestinal dysmotility investigated by capsule endoscopy
Authors
Charlotte M Hoog
Greger Lindberg
Urban Sjoqvist
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2007
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-7-29

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