Risk factors for incomplete small-bowel capsule endoscopy
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Updated: Jul 2, 2026

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Published on: July 11, 2025
Jessie Westerhof1, Rinse K Weersma, Jan J Koornstra
1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Background:
In 20% to 30% of capsule endoscopy (CE) procedures, the capsule does not reach the cecum within recording time, with incomplete imaging of the small bowel, which limits the value of CE.
Objective:
To identify possible risk factors for incomplete small-bowel CE examinations.
Design:
Data from consecutive CE procedures performed between September 2003 and August 2007 were analyzed. All patients had received the same preparation before the CE procedure, including the administration of a prokinetic agent.
Setting:
Single-center retrospective study.
Patients:
A total of 291 CE studies.
Main Outcome Measurements:
Data were collected regarding patient demographics and potential risk factors. Cecal incompletion rates were calculated. Risk factors were analyzed by using a binary regression analysis.
Results:
CE was incomplete in 55 cases (19%). The gastric transit time was significantly longer in patients with incomplete CE procedures than in patients with complete CE procedures (median 45 minutes vs 21 minutes, P= .005). Previous small-bowel surgery, hospitalization, moderate or poor bowel cleansing, and a gastric transit time longer than 45 minutes were identified as independent risk factors for incomplete CE procedures.
Limitation:
A retrospective study design.
Conclusions:
The identification of several risk factors for incomplete CE procedures allows for selectively targeting these factors in future procedures to reduce the risk of incomplete CE examinations.
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