Endoscopy 2019; 51(04): S30
DOI: 10.1055/s-0039-1681259
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: Capsule – enteroscopy Club B
Georg Thieme Verlag KG Stuttgart · New York

THE RELATION BETWEEN SMALL BOWEL CAPSULE ENDOSCOPY TRANSIT TIME AND DIAGNOSTIC YIELD AMONG PATIENTS PRESENTED WITH IRON DEFICIENCY ANAEMIA

H Ahmed
1   Barnsley District General Hospital, Gastroenterology Department, Barnsley, United Kingdom
,
B Uddin
1   Barnsley District General Hospital, Gastroenterology Department, Barnsley, United Kingdom
,
K Kapur
1   Barnsley District General Hospital, Gastroenterology Department, Barnsley, United Kingdom
,
E Said
1   Barnsley District General Hospital, Gastroenterology Department, Barnsley, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Investigate small bowel capsule transit times in relation to diagnostic yield and detection of angiodysplasias.

Methods:

We retrospectively reviewed small bowel capsule endoscopy (SBCE) reports of patients referred with iron deficiency anaemia (IDA) between April 2011 and April 2017 to our center. Exclusion criteria were; tests with capsule retention, inadequate intestinal views due to poor bowel preparation and unrecorded small bowel transit time (SBTT). We assessed demographics, significant outcomes that explain IDA, SBTT and number of detected angiodysplasias (AD). A positive diagnostic yield (PDY) was detection of a significant pathology that explains IDA.

Results:

We investigated a total of 766 SBCE reports with indication of IDA. Capsule retention was recorded in thirteen patients (1.7%). A total of 675 reports were analysed following the exclusion of 91 SBCE procedures as per the protocol above. Mean age was 61.6 years +/- 13.6. Male to female ratio: 313/362. The overall PDY was 24.3% (164/675) with a mean small bowel transit time (SBTT) of 236.73 minutes +/- 88.81. Mean SBTT was significantly higher in those with a PDY compared to those without (254.6 min +/- 89.2 vs. 231 min +/- 88, P value 0.003). While mean Age was significantly higher in those with a PDY (63.6yrs +/- 14.2 vs. 61yrs +/- 13.3, P = 0.029), Gender did not seem to have an impact on the outcome (Males = 24.9% vs. Females = 23.7%, p = 0.71). On subgroup analysis, SBTT did not influence the number of AD lesions detected (267.8 min +/- 103 for a single AD Vs 243.5 min +/-82.3 for multiple ADs, P = 0.17).

Conclusions:

In patients with IDA undergoing SBCE, identifying a clinically significant pathology increases significantly with the increase in SBTT and Age. We recommend either repeating test using bowel anti-motility drug or considering alternative diagnostic methods in tests with rapid SBTT.