Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Predictors of Small Bowel Transit Time for Capsule Endoscopy in Children with Inflammatory Bowel Disease

  • Itsuhiro Oka (Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development) ;
  • Rie Funayama (Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development) ;
  • Hirotaka Shimizu (Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development) ;
  • Ichiro Takeuchi (Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development) ;
  • Shuko Nojiri (Medical Technology Innovation Center, Juntendo University) ;
  • Toshiaki Shimizu (Department of Pediatrics, Juntendo University Faculty of Medicine) ;
  • Katsuhiro Arai (Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development)
  • Received : 2022.08.13
  • Accepted : 2023.06.08
  • Published : 2023.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule's transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods: We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children's hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results: Overall, 92 patients, aged 1-17 years, with inflammatory bowel disease (63 Crohn's disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: -58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion: Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.

Keywords

Acknowledgement

This study was supported by a National Grantin-Aid for the National Center for Child Health and Development (grant number 2019A-3 [to KA]) and a Health and Labour Sciences Research Grant for Research on Intractable Disease (grant number 20FC0201 [to KA]) from the Japanese Ministry of Health, Labour and Welfare. The study sponsors had no role in the study design; collection, analysis, and interpretation of data; writing of the report; or decision to submit the paper for publication.

References

  1. Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature 2000;405:417.
  2. Swaminath A, Legnani P, Kornbluth A. Video capsule endoscopy in inflammatory bowel disease: past, present, and future redux. Inflamm Bowel Dis 2010;16:1254-62. https://doi.org/10.1002/ibd.21220
  3. Nuutinen H, Kolho KL, Salminen P, Rintala R, Koskenpato J, Koivusalo A, et al. Capsule endoscopy in pediatric patients: technique and results in our first 100 consecutive children. Scand J Gastroenterol 2011;46:1138-43. https://doi.org/10.3109/00365521.2011.584900
  4. Tokuhara D, Watanabe K, Cho Y, Shintaku H. Patency capsule tolerability in school-aged children. Digestion 2017;96:46-51. https://doi.org/10.1159/000477579
  5. Delvaux M, Ben Soussan E, Laurent V, Lerebours E, Gay G. Clinical evaluation of the use of the M2A patency capsule system before a capsule endoscopy procedure, in patients with known or suspected intestinal stenosis. Endoscopy 2005;37:801-7. https://doi.org/10.1055/s-2005-870241
  6. Burgess CJ, McIntyre EC, Withers GD, Ee LC. Comparing swallowing of capsule to endoscopic placement of capsule endoscopy in children. JGH Open 2017;1:11-4. https://doi.org/10.1002/jgh3.12001
  7. Oikawa-Kawamoto M, Sogo T, Yamaguchi T, Tsunoda T, Kondo T, Komatsu H, et al. Safety and utility of capsule endoscopy for infants and young children. World J Gastroenterol 2013;19:8342-8. https://doi.org/10.3748/wjg.v19.i45.8342
  8. Barth BA, Donovan K, Fox VL. Endoscopic placement of the capsule endoscope in children. Gastrointest Endosc 2004;60:818-21. https://doi.org/10.1016/S0016-5107(04)02052-8
  9. Carey EJ, Heigh RI, Fleischer DE. Endoscopic capsule endoscope delivery for patients with dysphagia, anatomical abnormalities, or gastroparesis. Gastrointest Endosc 2004;59:423-6. https://doi.org/10.1016/S0016-5107(03)02683-X
  10. Uko V, Atay O, Mahajan L, Kay M, Hupertz V, Wyllie R. Endoscopic deployment of the wireless capsule using a capsule delivery device in pediatric patients: a case series. Endoscopy 2009;41:380-2. https://doi.org/10.1055/s-0029-1214491
  11. Bass LM, Misiewicz L. Use of a real-time viewer for endoscopic deployment of capsule endoscope in the pediatric population. J Pediatr Gastroenterol Nutr 2012;55:552-5. https://doi.org/10.1097/MPG.0b013e318261879d
  12. Holden JP, Dureja P, Pfau PR, Schwartz DC, Reichelderfer M, Judd RH, et al. Endoscopic placement of the small-bowel video capsule by using a capsule endoscope delivery device. Gastrointest Endosc 2007;65:842-7. https://doi.org/10.1016/j.gie.2007.01.033
  13. Jensen MK, Tipnis NA, Bajorunaite R, Sheth MK, Sato TT, Noel RJ. Capsule endoscopy performed across the pediatric age range: indications, incomplete studies, and utility in management of inflammatory bowel disease. Gastrointest Endosc 2010;72:95-102. https://doi.org/10.1016/j.gie.2010.01.016
  14. Gleason NR, Gallos G, Zhang Y, Emala CW. Propofol preferentially relaxes neurokinin receptor-2-induced airway smooth muscle contraction in guinea pig trachea. Anesthesiology 2010;112:1335-44. https://doi.org/10.1097/ALN.0b013e3181d3d7f6
  15. Desmet M, Vander Cruyssen P, Pottel H, Carlier S, Devriendt D, Van Rooy F, et al. The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery. Acta Anaesthesiol Scand 2016;60:335-42. https://doi.org/10.1111/aas.12675
  16. Wu J, Huang Z, Wang Y, Tang Z, Lai L, Xue A, et al. Clinical features of capsule endoscopy in 825 children: A single-center, retrospective cohort study. Medicine (Baltimore) 2020;99:e22864.
  17. Fritscher-Ravens A, Scherbakov P, Bufler P, Torroni F, Ruuska T, Nuutinen H, et al. The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study. Gut 2009;58:1467-72. https://doi.org/10.1136/gut.2009.177774
  18. Arguelles-Arias F, Donat E, Fernandez-Urien I, Alberca F, Arguelles-Martin F, Martinez MJ, et al. Guideline for wireless capsule endoscopy in children and adolescents: a consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases). Rev Esp Enferm Dig 2015;107:714-31. https://doi.org/10.17235/reed.2015.3921/2015
  19. Rezapour M, Amadi C, Gerson LB. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc 2017;85:1157-68.e2. https://doi.org/10.1016/j.gie.2016.12.024
  20. Barkin JS, O'Loughlin C. Capsule endoscopy contraindications: complications and how to avoid their occurrence. Gastrointest Endosc Clin N Am 2004;14:61-5. https://doi.org/10.1016/j.giec.2003.10.016
  21. Baichi MM, Arifuddin RM, Mantry PS. What we have learned from 5 cases of permanent capsule retention. Gastrointest Endosc 2006;64:283-7. https://doi.org/10.1016/j.gie.2006.02.036
  22. Rondonotti E, Herrerias JM, Pennazio M, Caunedo A, Mascarenhas-Saraiva M, de Franchis R. Complications, limitations, and failures of capsule endoscopy: a review of 733 cases. Gastrointest Endosc 2005;62:712-6; quiz 52, 54. https://doi.org/10.1016/j.gie.2005.05.002
  23. Sears DM, Avots-Avotins A, Culp K, Gavin MW. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc 2004;60:822-7. https://doi.org/10.1016/S0016-5107(04)02019-X
  24. Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, et al. The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease. Am J Gastroenterol 2006;101:2218-22. https://doi.org/10.1111/j.1572-0241.2006.00761.x
  25. Signorelli C, Rondonotti E, Villa F, Abbiati C, Beccari G, Avesani E, et al. Use of the Given Patency System for the screening of patients at high risk for capsule retention. Dig Liver Dis 2006;38:326-30. https://doi.org/10.1016/j.dld.2006.01.010
  26. Atay O, Mahajan L, Kay M, Mohr F, Kaplan B, Wyllie R. Risk of capsule endoscope retention in pediatric patients: a large single-center experience and review of the literature. J Pediatr Gastroenterol Nutr 2009;49:196-201. https://doi.org/10.1097/MPG.0b013e3181926b01
  27. de' Angelis GL, Fornaroli F, de' Angelis N, Magiteri B, Bizzarri B. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenterol 2007;102:1749-57; quiz 48, 58. https://doi.org/10.1111/j.1572-0241.2007.01209.x
  28. Thomson M, Fritscher-Ravens A, Mylonaki M, Swain P, Eltumi M, Heuschkel R, et al. Wireless capsule endoscopy in children: a study to assess diagnostic yield in small bowel disease in paediatric patients. J Pediatr Gastroenterol Nutr 2007;44:192-7. https://doi.org/10.1097/01.mpg.0000252196.91707.ff
  29. Cohen SA, Gralnek IM, Ephrath H, Saripkin L, Meyers W, Sherrod O, et al. Capsule endoscopy may reclassify pediatric inflammatory bowel disease: a historical analysis. J Pediatr Gastroenterol Nutr 2008;47:31-6. https://doi.org/10.1097/MPG.0b013e318160df85
  30. Urbain D, Tresinie M, De Looz D, Demedts I, Hauser B, Mana F, et al. Capsule endoscopy in paediatrics: multicentric Belgian study. Acta Gastroenterol Belg 2007;70:11-4.
  31. Ge ZZ, Chen HY, Gao YJ, Gu JL, Hu YB, Xiao SD. Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases. Eur J Pediatr 2007;166:825-9. https://doi.org/10.1007/s00431-006-0331-9
  32. Shamir R, Hino B, Hartman C, Berkowitz D, Eshach-Adiv O, Eliakim R. Wireless video capsule in pediatric patients with functional abdominal pain. J Pediatr Gastroenterol Nutr 2007;44:45-50. https://doi.org/10.1097/01.mpg.0000239737.64240.72
  33. Moy L, Levine J. Wireless capsule endoscopy in the pediatric age group: experience and complications. J Pediatr Gastroenterol Nutr 2007;44:516-20. https://doi.org/10.1097/MPG.0b013e3180335548
  34. Guilhon de Araujo Sant'Anna AM, Dubois J, Miron MC, Seidman EG. Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial. Clin Gastroenterol Hepatol 2005;3:264-70.
  35. Iwama I, Shimizu H, Nambu R, Okuhira T, Kakuta F, Tachibana N, et al. Efficacy and safety of a capsule endoscope delivery device in children. Eur J Gastroenterol Hepatol 2019;31:1502-7. https://doi.org/10.1097/MEG.0000000000001513
  36. Quan C, Chen G, Lee-Henderson M, Kalpakian M, Chan S, Tran T, et al. Overtube-assisted placement of wireless capsule endoscopy device. Gastrointest Endosc 2005;61:914-6. https://doi.org/10.1016/S0016-5107(05)00293-2
  37. Toth E, Fork FT, Almqvist P, Thorlacius H. Endoscopy-assisted capsule endoscopy in patients with swallowing disorders. Endoscopy 2004;36:746-7; author reply 747-8. https://doi.org/10.1055/s-2004-825685
  38. Skogestad E, Tholfsen JK. Capsule endoscopy: in difficult cases the capsule can be ingested through an overtube. Endoscopy 2004;36:1038.
  39. Lee MM, Jacques A, Lam E, Kwok R, Lakzadeh P, Sandhar A, et al. Factors associated with incomplete small bowel capsule endoscopy studies. World J Gastroenterol 2010;16:5329-33. https://doi.org/10.3748/wjg.v16.i42.5329
  40. Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc 2009;69:74-80. https://doi.org/10.1016/j.gie.2008.04.034