Background and study aims: In 20 % of patients, capsule endoscopes fail to reach the cecum within the 8-hour
battery life. This is the most common cause of incomplete small-bowel examination.
The aim of this study was to determine whether keeping patients in the right lateral
position (RLP) improves the complete examination rate (CER) of the small bowel by
reducing the gastric transit time (GTT) of the capsule.
Patients and methods: Patients were randomized into the RLP group (n = 30) or control group (n = 30). Patients
in the RLP group were instructed to lie on their right side postingestion until the
capsule had passed through the pylorus. The patients in the control group were free
to walk or sit (upright position). The main outcomes were the CER and GTT between
the groups.
Results: There was no significant difference in the sex, mean age, and indications between
the two groups. The CER was significantly higher in the RLP group than in the controls
(96.7 % vs. 73.3 %, P = 0.030). GTT was significantly shorter in the RLP group than in the control group (medians
[range]: 32 [8-108] vs. 58 [9-208] minutes, P = 0.007). Small-bowel imaging time was significantly longer in the RLP group than in
the control group (372 [135-425] vs. 292 [146-422] minutes, P = 0.039). There were no significant differences in the diagnostic yields between the
two groups.
Conclusions: Placing patients in the RLP after ingestion of the capsule endoscope and before the
capsule enters the pylorus is a simple method to increase the CER of the small bowel
by reducing the GTT of the capsule.
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Z.-S. Li, MD
Department of Gastroenterology
Digestive Endoscopy Center
Changhai Hospital
The Second Military Medical University
174 Changhai Road
Shanghai, 200433
China
Fax: +86-21-55621735
Email: zhaoshenli@hotmail.com
