Colon capsule endoscopy: what factors predict an incomplete examination?

The most important factors for a successful colon capsule endoscopy (CCE) study are the quality of bowel preparation and the capsule excretion during battery life. Incomplete conventional colonoscopy is one of the main indications for CCE. The aim of this study was to analyze clinical and demographic factors for incomplete CCE after an incomplete conventional colonoscopy.

A retrospective single-center study was conducted including patients who underwent CCE after an incomplete colonoscopy (IC). Complete CCE was defined as capsule excretion or visualization of hemorrhoidal pedicles within battery time. Demographic (gender and age) and clinical data (obesity, smoking history, diabetes mellitus, hypothyroidism, constipation, depression, psychotropic medication use and history of abdominal or pelvic surgery) were collected.

A total of 197 patients were included (mean age 67 ± 10 years; 71.6% female). Complete CCE was achieved in 133 (67.5%) of cases. Adequate bowel preparation was observed in 145 (73.6%) of cases. The most common causes of incomplete conventional colonoscopy were colonic fixed angulation (56.3%) and irreducible loop (42.1%), with no significant difference in capsule completion between these groups (p = 0.770). Obesity (OR 5.328; 95% CI 1.735-16.369; p = 0.003) and constipation (OR 2.999; 95% CI 1.264-7.114; p = 0.013) were independently associated with incomplete CCE.

Obesity and constipation are risk factors for incomplete CCE. Adjustments or intensification of bowel preparation protocols may improve completion rates in these patients.