Patient Factors Contributing to Wireless pH Monitoring Intolerance

The aim of our study is to evaluate for contributing factors related to intolerance of wireless pH capsule endoscopy.

Wireless capsule endoscopy has been a key diagnostic modality in the quantification of esophageal acid exposure time. Common complications are wireless capsule retention and postdeployment pain; however, some patients experience significant intolerance after the procedure.

Retrospective study of patients in the adult gastroenterology department who have had a wireless pH monitoring from January 2017 to June 2023. Descriptive statistics and pairwise statistical tests of association were computed for each clinical covariate of interest. In addition, a multivariate logistic regression model was used to jointly infer the relationship between postprocedure pain and numerous covariates.

Of the 204 participants who underwent the wireless pH capsule placement, 18 (8.73%) patients had documented severe postprocedural pain. The covariates retention (P<0.001) and irritable bowel syndrome (P=0.015) were inferred to have statistically significant associations with postprocedure pain. The odds of a patient with a history of depression experiencing postprocedure pain are estimated to be 8.18 (95% CI: 1.53-53.5; P=0.019) times the odds of a patient without depression. The odds ratio of antidepressant use was estimated to be 0.17 (95% CI: 0.03-0.77; P=0.029) times (ie, 83%) less than the odds without antidepressant use.

IBS diagnosis, depression, and capsule esophageal retention were each associated with postprocedural intolerance. Interestingly, antidepressant use may be protective, possibly related to the neuromodulating properties of these medications. Further evaluation is needed to validate this observation.