Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation
| Autor: | William D. Chey, Gregory E. Wilding, Stephen M. Wiener, William L. Hasler, Jason Baker, Braden Kuo, Monthira Maneerattanaporn, Allen Lee |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Gastroparesis Time Factors Constipation Physiology Small intestinal dysmotility Contrast Media Capsule Endoscopy Gastroenterology Internal medicine Intestine Small Prevalence Humans Medicine Slow transit constipation Gastrointestinal Transit Radionuclide Imaging Aged Retrospective Studies Aged 80 and over Gastric emptying business.industry Stomach digestive oral and skin physiology Retrospective cohort study Middle Aged Hepatology medicine.disease medicine.anatomical_structure Gastric Emptying Barium Female medicine.symptom Gastrointestinal Motility business |
| Zdroj: | Digestive Diseases and Sciences. 56:2928-2938 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-011-1751-6 |
| Popis: | Background The prevalence of generalized transit delay and relation to symptoms in suspected gastroparesis, intestinal dysmotility, or slow transit constipation are unknown. Aims The aims of this study were (1) to define prevalence of generalized dysmotility using wireless motility capsules (WMC), (2) to relate to symptoms in suspected regional delay, (3) to compare results of WMC testing to conventional transit studies to quantify new diagnoses, and (4) to assess the impact of results of WMC testing on clinical decisions. Methods WMC transits were analyzed in 83 patients with suspected gastroparesis, intestinal dysmotility, or slow transit constipation. Results Isolated regional delays were observed in 32% (9% stomach, 5% small bowel, 18% colon). Transits were normal in 32% and showed generalized delays in 35%. Symptom profiles were similar with normal transit, isolated delayed gastric, small intestinal, and colonic transit, and generalized delay (P = NS). Compared to conventional tests, WMC showed discordance in 38% and provided new diagnoses in 53%. WMC testing influenced management in 67% (new medications 60%; modified nutritional regimens 14%; surgical referrals 6%) and eliminated needs for testing not already done including gastric scintigraphy (17%), small bowel barium transit (54%), and radioopaque colon marker tests (68%). Conclusions WMC testing defines localized and generalized transit delays with suspected gastroparesis, intestinal dysmotility, or slow transit constipation. Symptoms do not predict the results of WMC testing. WMC findings provide new diagnoses in [50%, may be discordant with conventional tests, and can influence management by changing treatments and eliminating needs for other tests. These findings suggest potential benefits of this method in suspected dysmotility syndromes and mandate prospective investigation to further define its clinical role. |
| Databáze: | OpenAIRE |
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