The Relationship between Physical Activity Level and Completion Rate of Small Bowel Examination in Patients Undergoing Capsule Endoscopy
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- Shibuya Tomoyoshi
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Mori Hiroki
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Takeda Tsutomu
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Konishi Masae
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Fukuo Yuka
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Matsumoto Kenshi
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Beppu Kazuko
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Sakamoto Naoto
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Osada Taro
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Nagahara Akihito
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Otaka Michiro
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Ogihara Tatsuo
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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- Watanabe Sumio
- Department of Gastroenterology, Juntendo University School of Medicine, Japan
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Abstract
Objective Capsule endoscopy (CE) allows direct examination of the small bowel in a safe, noninvasive and well-tolerated manner. Nonetheless, experience indicates failure to reach the cecum in 20-30% of patients within the 8 hour battery life. Attempts to improve the completion rate (CR) as defined by reaching the cecum have been unsuccessful. This study was to investigate the relationship between patients' physical activity and CR.<br> Methods Between January 2009 and January 2010, 76 patients (44 men, 32 women; median age 64.5 yr) underwent CE for the diagnosis of small intestinal disorders. Indications for CE were obscure gastrointestinal bleeding/anemia (62 cases), others (14 cases). Patients were divided into an outpatient group (n=23), mild bed rest group (n=35) and strict bed rest group (n=18).<br> Results For all patients, the average gastric transit time was 65.5 minutes, small bowel transit time was 301.4 minutes and the CR was 86.8%. However, the CR was 100% (23/23) in the outpatient group, an 85.7% (30/35) in the mild bed rest group, and 72.2% (13/18) in the strict bed rest group. The CR increased with physical activity of patients by Cochran-Armitage Trend Test (p=0.009). In multivariate logistic regression analyses, low physical activity was a significant risk factor for failure to reach the cecum during CE examination; adjusted OR: 3.39, 95% CI: 1.01-11.42 (p=0.048).<br> Conclusion Our observations suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. Further, for CE, inconvenient bowel preparations like the use of polyethylene glycol may be avoided.<br>
Journal
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- Internal Medicine
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Internal Medicine 51 (9), 997-1001, 2012
The Japanese Society of Internal Medicine
