Capsule Endoscopy Transit Time to Duodenum: Relation to Patient Demographics

Area of Science:

• Gastroenterology
• Medical Devices
• Clinical Trials

Background:

• Anesthesia guidelines recommend fasting for at least two hours to minimize aspiration risk during endoscopic procedures.
• The American Society for Gastrointestinal Endoscopy (ASGE) permits oral fluid intake up to eight hours before procedures.
• Observed cancellations of endoscopy procedures due to patients consuming liquids within 4-8 hours of the procedure time.

Purpose of the Study:

• To document gastric transit time (GTT) and small bowel transit time (SBTT) using pill endoscopy data.
• To investigate the relationship between patient factors (CKD, DM, nutritional status, obesity) and GTT/SBTT.
• To provide objective data to support adherence to national guidelines and reduce procedure delays.

Main Methods:

• Retrospective review of adult capsule endoscopy (PillCam™ SB 3) studies.
• Abstraction of past medical history and laboratory data from electronic medical records.
• Comparison of mean GTT and SBTT (in minutes) across patient subgroups with conditions like diabetes mellitus and chronic kidney disease.

Main Results:

• The mean GTT for 159 patients was 44 minutes (median 19 minutes); 85% had GTT < 60 minutes.
• No statistically significant differences in GTT or SBTT were found based on CKD status, albumin levels, diabetes mellitus, or BMI.
• Four patients (excluded from analysis) had capsules that did not pass out of the stomach.

Conclusions:

• Pill endoscopy data indicate that mean GTT is approximately 44 minutes, with 85% of patients completing GTT in under 60 minutes.
• Common patient factors such as diabetes mellitus and chronic kidney disease do not significantly prolong GTT or SBTT.
• These findings support the safety of conducting endoscopic procedures in most patients within 60 minutes of liquid ingestion, aligning with anesthesia and ASGE guidelines.