Patency capsule ‒ Insights from a nationwide survey in clinical practice

This nationwide survey by the Small Bowel Working Group of the Spanish Society of Digestive Endoscopy (SBWG-SEED) assessed the clinical use of the PillCam Patency® capsule (PC) in Spain. Although the PC helps to reduce the risk of video capsule endoscopy (VCE) retention, current guidelines do not provide sufficiently detailed and standardized protocols for its use. Seventy-five gastroenterologists with VCE experience completed the survey. Most worked in public hospitals (66.2%) and had over five years of experience (52%). The PC was primarily used in high-risk patients, such as those with suspected or confirmed Crohn's disease (CD) (70 and 62% of cases with this indication respectively), small bowel tumors (58%), chronic NSAIDs use (58%), and prior radiation therapy (50%). Prescription responsibility varied, with 48% of decisions made collaboratively. Pre-procedure preparation was inconsistent: 60% of respondents did not perform specific bowel preparation, and 41% obtained combined consent for PC and VCE. Post-ingestion: 75% confirmed PC passage before VCE and mostly through radiological methods (93%). Although consensus was found in some answers, clinical practices varied significantly which highlights the need for standardized guidelines to optimize patient management and clinical consistency.