THE EFFECT OF SMALL BOWEL TRANSIT TIME ON THE DIAGNOSTIC YIELD OF PATIENTS WITH SUSPECTED SMALL BOWEL CROHN'S

Aims:

Small Bowel capsule endoscopy has a mentionable role in diagnosing and confirming small bowel crohn's disease. Small bowel transit time varies from minutes to hours between different individuals. We aimed to assess capsule endoscopy (CE) diagnostic yield (DY) and it's relation to small bowel transit time (SBTT) among patients undergoing the test for suspected small bowel (SB) crohn's.

Methods:

We retrospectively reviewed and analysed the CE reports of all patients underwent CE test for suspected SB crohn's between April 2011 and April 2017. Tests with unknown SBTT were excluded. We assessed demographics, complications, SBTT and positive diagnostic yield (PDY) among the cohort. PDY was defined as tests with results which could represent crohn's disease. Data were analysed using SPSS.

Results:

Ninety six CE test were done. Three tests were excluded due to unavailable SBTT on report. One patient (1%) had retained small bowel capsule due to stricture in spite of passage of pre-test patency capsule. The stricture improved with steroid therapy allowing the CE to pass. Ninety two CE reports were analysed. While mean SBTT for patients with PDY was insignificantly higher compared to those without PDY (273.5 min +/- 104.7 vs. 238.4 min +/- 89.6, p Value = 0.09), the mean age was similar on both groups (40.2yrs +/- 15.3 vs. 43.7yrs +/- 16, p Value = 0.3). PDY was insignificantly higher in males compared to females (44.8 vs 37.1%, p Value = 0.22). Overall DY among all patients test was 35.9%.

Conclusions:

CE is a safe, non-invasive and feasible test to investigate the small bowel for suspected crohn's disease. Even though our study suggests that prolonged SBTT may be associated with increased DY, we recommend that large multi-centre study to be carried out to further evaluate this association.