Diagnostic Yield and Clinical Impact of Video Capsule Endoscopy in Patients with Chronic Diarrhea: A Korean Multicenter CAPENTRY Study.

Abstract

BACKGROUND/AIMS:

In some cases, chronic diarrhea is unexplained, and small bowel disorders may be one of the causes. The aim of this study was to assess the diagnostic yield and clinical impact of video capsule endoscopy (VCE) in patients with chronic diarrhea.

METHODS:

We retrospectively analyzed records from October 2002 to August 2013 in the VCE nationwide database registry (n=2,964). Ninety-one patients from 15 medical centers (60 males and 31 females; mean age, 47±19 years) were evaluated for VCE as a result of chronic diarrhea.

RESULTS:

The duration of chronic diarrhea was 8.3±14.7 months. The positive diagnostic yield of VCE was 42.9% (39/91). However, 15.4% (14/91) exhibited an inconsistent result, and 41.8% (38/91) were negative. Abnormal findings consistent with chronic diarrhea included erosions/aphthous ulcers (19.8%), ulcers (17.6%), mucosal erythema (3.3%), edema (1.1%), and luminal narrowing (1.1%). The most common diagnoses were functional diarrhea associated with irritable bowel syndrome in 37 patients (40.7%) and Crohn's disease in 18 patients (19.8%). After VCE examination, the diagnosis was changed in 34.1% of the patients (31/91). Hematochezia (odds ratio [OR], 8.802; 95% confidence interval [CI], 2.126 to 36.441) and hypoalbuminemia (OR, 4.811; 95% CI, 1.241 to 18.655) are predictive factors of a positive diagnostic yield.

CONCLUSIONS:

VCE had a favorable diagnostic yield and clinical impact on the management of patients with chronic diarrhea.

• Authors: Hyun Joo Song, Jeong Seop Moon, Seong Ran Jeon, Jin-Oh Kim, Jinsu Kim, Dae Young Cheung, Myung-Gyu Choi, Yun Jeong Lim, Ki-Nam Shim, Byong Duk Ye, Jae Hee Cheon, Cheol Hee Park, Hyun-Soo Kim, Ji Hyun Kim, Dong Kyung Chang, Jae Hyuk Do, Kyeong Ok Kim, Byung Ik Jang, Sung-Jae Shin, Korean Gut Image Study Group
• Journal: Gut and liver (Gut Liver) Vol. 11 Issue 2 Pg. 253-260 (Mar 15 2017) ISSN: 2005-1212 [Electronic] Korea (South)
• PMID: 27840367 (Publication Type: Evaluation Study, Journal Article, Multicenter Study)

Topics

• Adult
• Aged
• Capsule Endoscopy (methods, statistics & numerical data)
• Chronic Disease
• Crohn Disease (complications, diagnostic imaging)
• Diarrhea (etiology)
• Female
• Humans
• Intestinal Diseases (complications, diagnostic imaging)
• Irritable Bowel Syndrome (complications, diagnostic imaging)
• Male
• Middle Aged
• Predictive Value of Tests
• Retrospective Studies