Applicability of colon capsule endoscopy as pan-endoscopy: From bowel preparation, transit, and rating times to completion rate and patient acceptance

Abstract

Background and study aims Colon capsule endoscopy (CCE) has the potential to explore the entire gastrointestinal tract. The aim of this study was to assess the applicability of CCE as pan-endoscopy. Patients and methods Healthy participants received CCE with bowel preparation (bisacodyl, polyethylene electrolyte glycol (PEG) + ascorbic acid) and booster regimen (metoclopramide, oral sulfate solution (OSS)). For each segment of the gastrointestinal tract, the following quality parameters were assessed: cleanliness, transit times, reading times, patient acceptance and safety of the procedure. When all gastrointestinal segments had cleansing score good or excellent, cleanliness of the whole gastrointestinal tract was assessed as good. Participants’ expected and perceived burden was assessed by questionnaires and participants were asked to grade the procedure (scale 0–10). All serious adverse events (SAEs) were documented. Results A total of 451 CCE procedures were analyzed. A good cleansing score was achieved in the stomach in 69.6%, in the SB in 99.1 % and in the colon in 76.6 %. Cleanliness of the whole gastrointestinal tract was good in 52.8 % of the participants. CCE median transit time of the whole gastrointestinal tract was 583 minutes IQR 303–659). The capsule reached the descending colon in 94.7 %. Median reading time per procedure was 70 minutes (IQR 57–83). Participants graded the procedure with a 7.8. There were no procedure-related SAEs. Conclusions CCE as pan-endoscopy has shown to be a safe procedure with good patient acceptance. When cleanliness of all gastrointestinal segments per patient, completion rate and reading time will be improved, CCE can be applied as a good non-invasive alternative to evaluate the gastrointestinal tract.

Obscure Gastrointestinal Bleeding and Capsule Endoscopy: A Win-Win Situation or Not?

“…A study conducted in 2021 by Vuik et al using PillCam COLON 2 on 451 participants concluded that colon capsule endoscopy (CCE) was safe and had good acceptance among patients [ 26 ]. CCE received a score of 7.8 on a scale of 1-10; additionally, 91.1% of the participants said they would consider having CCE sometime in the future [ 26 ]. Only 6.6% of those polled said that they would tell others to avoid CCE [ 26 ].…”

“…CCE received a score of 7.8 on a scale of 1-10; additionally, 91.1% of the participants said they would consider having CCE sometime in the future [ 26 ]. Only 6.6% of those polled said that they would tell others to avoid CCE [ 26 ]. The most cumbersome element of the CCE process for most participants (89.2%) was bowel preparation, while for others it was the day of the procedure (8%) or stomach issues after the procedure (3%) [ 26 ].…”

“…Only 6.6% of those polled said that they would tell others to avoid CCE [ 26 ]. The most cumbersome element of the CCE process for most participants (89.2%) was bowel preparation, while for others it was the day of the procedure (8%) or stomach issues after the procedure (3%) [ 26 ].…”

“…To deal with retention, Fairbrass et al suggested a pre-test with a patency capsule before undergoing CE [ 44 ]. It cannot be used in patients with motility disorders for fear of retention, and even in patients who are allergic or have an MRE appointment within 14 days of ingestion of the capsule [ 26 ]. The main limitation of CE is that it is simply diagnostic, with no therapeutic benefits, such as conducting biopsies or delivering therapy, except for redirecting additional therapeutic steps [ 13 ].…”

Light flickering through a narrow window opening in capsule panendoscopy

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We read with great interest the paper by Vuik et al [1], reporting a single-center experience with application of colon capsule endoscopy as a panendoscopic tool. Both colon capsules and the newer Pill-Cam Crohn's capsule have been used for panendoscopy in several settings.

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