Factors that affect gastric passage of video capsule

Gastric retention and delayed gastric emptying of the video capsule are major limitations. We retrospectively studied gastric transit time, gastric retention, and completeness of capsule endoscopy (CE) in relation to the conditions in which it was performed.

From May 2002 to September 2004, CE was performed in 190 patients (92 men; mean age, 58.4 years, range 16-91 years). Patients were stratified according to the way CE was performed (hospital day setting, outpatient, or ongoing hospitalization), and the recordings were analyzed to measure gastric retention, gastric transit time, and the completeness of the examinations.

CE examination was performed in a hospital day setting in 100 patients, in an outpatient setting in 61, and during hospitalization in 29. Gastric retention of the capsule occurred in 8 of 190 patients (4.2%) (5 women, 3 men; mean age, 37.9 years). Gastric retention occurred during hospitalization in 7/29 (24.1%) and in hospital day setting in one of 100. Ongoing hospitalization was statistically associated with an increased risk of gastric capsule retention (p < 0.0001). The cecum was reached in 165/190 (87%), and ongoing hospitalization was associated with a lower rate of complete examinations (p < 0.001). Small-bowel transit time was similar, regardless of the circumstances of CE performance.

Ongoing hospitalization is a major cause of gastric retention and incomplete examination by CE. Therefore, CE performance during ongoing hospitalization may require the use of a prokinetic agent.