A pilot study of capsule endoscopy after a standard meal for the detection and grading of oesophageal varices in cirrhotic patients.

Abstract

BACKGROUND:

Capsule endoscopy has been proposed as an alternative to fibreoptic endoscopy for oesophageal varices evaluation in cirrhotics. However, it shows only moderate sensitivity compared to fibreoptic endoscopy.

AIM:

To compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity.

METHODS:

Twenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy.

RESULTS:

Post-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%).

CONCLUSIONS:

Post-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics.

• Authors: Brigida Eleonora Annicchiarico, Maria Elena Riccioni, Massimo Siciliano, Riccardo Urgesi, Cristiano Spada, Gianluigi Caracciolo, Antonio Gasbarrini, Guido Costamagna
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 46 Issue 11 Pg. 997-1000 (Nov 2014) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 25192604 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Capsule Endoscopy (methods)
• Esophageal and Gastric Varices (diagnosis, etiology)
• Esophagoscopy (instrumentation, methods)
• Female
• Fiber Optic Technology
• Humans
• Hypertension, Portal (diagnosis, etiology)
• Italy
• Liver Cirrhosis (complications, diagnosis)
• Male
• Meals
• Middle Aged
• Pilot Projects
• Postprandial Period
• Predictive Value of Tests
• Risk Assessment
• Sampling Studies
• Sensitivity and Specificity
• Severity of Illness Index