Z Gastroenterol 2012; 50 - A57
DOI: 10.1055/s-0032-1312411

The effect of metoclopramide on oro-cecal transit time in patients with small bowel capsule endoscopy

P Pák 1, G Balogh 2, T Velkei 3, Z Dubravcsik 3, A Szepes 3, L Madácsy 3
  • 12nd Department of Medicine, Vaszary Kolos Hospital, Esztergom, Hungary
  • 2General, Thoracic and Vascular Surgery, Kaposi Mór Teaching Hospital, Kaposvár, Hungary
  • 3Bács-Kiskun County Hospital, Teaching Hospital of the University of Szeged, Department of Gastroenterology, Kecskemét, Hungary

Introduction: Small bowel capsule endoscopy (SBCE) reaches the cecum in only about 80–90% of all cases. The clinical efficacy of prokinetics during SBCE to achieve complete small bowel visualisation and accelerate oro-cecal transit time (OCTT) has not been clearly established. The aim of the present study was to determine if metoclopramide adminstration during SBCE could influence capsule propagation.

Patients and Methods: 68 consecutive patients who underwent GIVEN SB2 CE were classified to receive either intravenous (IVM group, 10 patients) or oral (POM group, 28 patients) administration of 10mg metoclopramid. 30 patients received no prokinetic treatment at all (control group).

Results: The mean gastric transit time (GTT) was significantly shorter in the IVM group (GTT: 12.8 + 7.1min) as compared to the POM group (GTT: 44.3 + 47.7min) or to the control group (GTT: 40.5 + 45.5min) (P<0.04). The mean SBTT and the OCTT were 145.7 + 91.0min, 158.5 + 91.2.4min in the IVM group, 199.1 + 103.9min, 243.4 + 98.6min in the POM group, and 258.8 +/- 112.2min, 283.8 +/- 115.5min in the control group. (p=0.17, p=0.02). In the IVM group all capsules reached the coecum, in contrast 2 out of 28 and 1 out of 30 SBCE were incomplete in the POM and in the control group, respectively. The quantitative analysis of the small bowel cleanliness (green color proportion in the color bar) depicted positive linear correlation with the SBTT (R=0.687).

Conclusions: Both intravenous and oral administration of metoclopramide significantly accelerated GTT and OCTT during SBCE. Intravenous metoclopramide increases the likelihood of a complete small-bowel examination and improves mucosal visualization in patients undergoing capsule endoscopy.