scholarly journals Bile pigment in small-bowel water content may reflect bowel habits: a retrospective analysis of a capsule endoscopy imaging series

2020 ◽  
Author(s):  
Taiki Aoyama ◽  
Akira Fukumoto ◽  
Kenjiro Shigita ◽  
Naoki Asayama ◽  
Shinichi Mukai ◽  
...  
Keyword(s):  
Bile Acid ◽  
Small Bowel ◽  
Water Content ◽  
Capsule Endoscopy ◽  
Color Space ◽  
Bile Pigment ◽  
Bile Pigments ◽  
Normal Bowel ◽  
Bowel Habits ◽  
The Impact

Abstract Background: Pigmented bile salts darken the small-bowel lumen and are present with bile acid, which is involved in the development of bowel habits. The small-bowel water content (SBWC) in the ileum could represent the colonic environment, but no studies have focused on this feature. However, measurement of crude SBWC can be challenging because of the technical difficulty of the endoscopic approach without preparation. Our aim was to evaluate optically active bile pigments in the SBWC of patients with abnormal bowel habits using capsule endoscopy (CE) to investigate the impact of bile acid on bowel habits. Methods: The study population included 37 constipated patients, 20 patients with diarrhea, and 77 patients with normal bowel habits who underwent CE between January 2015 and May 2018. Patients with secondary abnormal bowel habits were excluded. In addition to conventional imaging, we used flexible spectral imaging color enhancement (FICE) setting 1 imaging, in which the effects of bile pigments on color are suppressed. Intergroup color differences of SBWC in the ileum (ΔE) were evaluated from conventional and FICE setting 1 images. Color values were assessed using the CIE L*a*b* color space. Differences in SBWC lightness (black to white, range 0–100) were also evaluated. Results: The ΔE values from the comparison of conventional images between patients with constipation and with normal bowel habits and between patients with diarrhea and with normal bowel habits were 12.4 and 11.2, respectively. These values decreased to 4.4 and 3.3, respectively, when FICE setting 1 images were evaluated. Patients with constipation and diarrhea had significantly brighter (34.4 versus 27.6, P < .0001) and darker (19.6 versus 27.6, P < .0001) SBWC lightness, respectively, than patients with normal bowel habits. The FICE setting 1 images did not reveal significant differences in SBWC lightness between those with constipation and with normal bowel habits (44.1 versus 43.5, P = .83) or between those with diarrhea and with normal bowel habits (39.1 versus 43.5, P = .20). Conclusions : Differences in SBWC color and darkness in the ileum appear to be attributable to bile pigments. Therefore, bile pigments in SBWC may reflect bowel habits.

scholarly journals Bile pigment in small-bowel water content reflects bowel habits: a retrospective analysis of a capsule-endoscopy imaging series

2019 ◽  
Author(s):  
Taiki Aoyama ◽  
Akira Fukumoto ◽  
Kenjiro Shigita ◽  
Naoki Asayama ◽  
Shinichi Mukai ◽  
...  
Keyword(s):  
Bile Acid ◽  
Small Bowel ◽  
Water Content ◽  
Capsule Endoscopy ◽  
Bowel Habit ◽  
Bile Pigment ◽  
Bile Pigments ◽  
Normal Bowel ◽  
Bowel Habits ◽  
The Impact

Abstract Background Pigmented bile salts darken the small-bowel lumen and are present with bile acid, which is involved in the development of bowel habits. The small-bowel water content (SBWC) in the ileum could represent the colonic environment, although no studies have focused on this feature. However, measurement of the crude SBWC can be challenging because of the technical difficulty of the endoscopic approach without preparation. Our aim was to evaluate optically active bile pigments in the SBWC of patients with abnormal bowel habits using capsule endoscopy (CE), to investigate the impact of bile acid on bowel habits. In addition to conventional imaging, we used flexible spectral imaging color enhancement (FICE) setting 1 imaging, in which the effects of bile pigments on color are suppressed.Methods The study population included 37 constipated patients, 20 patients with diarrhea, and 77 patients with normal bowel habits who underwent CE between January 2015 and May 2018. Patients with secondary abnormal bowel habits were excluded. Intergroup color differences of SBWC in the ileum (ΔE) were evaluated from conventional and FICE setting 1 images. Color values were assessed using the CIE L*a*b* color space. Differences in lightness (black to white, range 0 to 100) of SBWC were also evaluated.Results Values of ΔE calculated from comparisons of conventional images of constipated and normal-bowel-habit patients, and patients with diarrhea and normal-bowel-habit patients were 11.3 and 10.7, respectively. These values decreased to 3.9 and 3.2, respectively, when FICE setting 1 images were evaluated. The SBWC lightness of patients with constipation and diarrhea was significantly brighter (34.0 versus 27.2, P < .0001) and darker (18.8 versus 27.2, P < .0001), respectively, compared with the normal-bowel-habit patients. Examination of the FICE setting 1 images did not reveal significant differences in SBWC lightness between the constipated and normal-bowel-habit groups (44.7 versus 46.7, P = .33) or between the diarrhea and normal-bowel-habit groups (44.7 versus 42.3, P = .39).Conclusions Differences in color and darkness of the SBWC in the ileum appear to be attributable to bile pigments. Therefore, bile pigments in SBWC could reflect bowel habits.

scholarly journals Bile pigment in small-bowel water content may reflect bowel habits: a retrospective analysis of a capsule endoscopy imaging series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Taiki Aoyama ◽  
Akira Fukumoto ◽  
Kenjiro Shigita ◽  
Naoki Asayama ◽  
Shinichi Mukai ◽  
...  
Keyword(s):  
Small Bowel ◽  
Water Content ◽  
Retrospective Analysis ◽  
Capsule Endoscopy ◽  
Bile Pigment ◽  
Bowel Habits

scholarly journals New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Pedro Boal Carvalho ◽  
Bruno Rosa ◽  
Maria João Moreira ◽  
José Cotter
Keyword(s):  
Small Bowel ◽  
Drug Use ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Decisive Role ◽  
Bleeding Risk ◽  
Obscure Gastrointestinal Bleeding ◽  
Anticoagulant Drug ◽  
The Impact

Objectives.Small bowel capsule endoscopy (SBCE) plays a decisive role in the obscure gastrointestinal bleeding (OGIB) diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE.Methods.Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential), P1 (uncertain bleeding potential: erosions), and P2 (high bleeding potential: angioectasias, ulcers, and tumors). We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE.Results.One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4%) were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11,P=0.026). We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE.Conclusions.Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

scholarly journals Bowel Preparation for Small Bowel Capsule Endoscopy: Is There Still a Role for Polyethylene Glycol?

2020 ◽  
Vol 11 (03) ◽  
pp. 215-222
Author(s):  
Paul Collins ◽  
Neil Haslam ◽  
Anthony Morris ◽  
Thomas Skouras ◽  
Ashley Bond
Keyword(s):  
Polyethylene Glycol ◽  
Small Bowel ◽  
Transit Time ◽  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Diagnostic Yield ◽  
Statistical Significance ◽  
Deficiency Anemia ◽  
Bowel Cleansing ◽  
The Impact

Abstract Objectives This study aimed to assess the impact of polyethylene glycol (PEG) bowel cleansing on performance characteristics of small bowel capsule endoscopy (SBCE). Materials and Methods Data from consecutive patients undergoing SBCE in the period before and after the introduction of PEG 2 L bowel cleansing with PEG were collated retrospectively. The indication, diagnostic yield (DY), clinical outcome, small bowel transit time, gastric transit time, and completion rate were recorded for each procedure. Results Data from 286 patients were analyzed. PEG 2 L was not superior to 12-hour fasting for DY (66 [53%] vs. 76 [47%] patients [p = 0.348]), or DY for significant findings (findings requiring a further intervention or investigation; 29 [23%] vs. 52 [32%] patients [p = 0.090]).There was a trend toward an increased DY for significant findings in patients undergoing investigation for iron-deficiency anemia (IDA) receiving PEG 2 L that just failed to meet statistical significance (13 [31%] and 25 [21%] patients, respectively [p = 0.06]). Transit times and completion rates were unaffected by bowel cleansing. Conclusion Bowel cleansing with PEG 2 L is not superior to fasting for overall DY in SBCE. PEG 2 L may confer an advantage for the detection of significant lesions in patient with IDA. Further investigation of optimal modes of bowel preparation is indicated.

scholarly journals Tailoring Crohn's disease treatment: The impact of small bowel capsule endoscopy

2014 ◽  
Vol 8 (12) ◽  
pp. 1610-1615 ◽  
Author(s):  
José Cotter ◽  
Francisca Dias de Castro ◽  
Maria João Moreira ◽  
Bruno Rosa
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Disease Treatment ◽  
The Impact

Sa1588 Capsule Endoscopy With Flexible Spectral Imaging Color Enhancement Reduces the Bile-Pigments Effect and Improves the Detectability of Small Bowel Lesions

2012 ◽  
Vol 75 (4) ◽  
pp. AB211-AB212
Author(s):  
Eiji Sakai ◽  
Hiroki Endo ◽  
Shingo Kato ◽  
Eiji Yamada ◽  
Hidenori Ohkubo ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Spectral Imaging ◽  
Bile Pigments ◽  
Color Enhancement

Su1203 The Impact of Capsule Endoscopy Visualization on the Ability to Identify Small Bowel Pathologies

2017 ◽  
Vol 85 (5) ◽  
pp. AB312-AB313
Author(s):  
Neil B. Marya ◽  
Adarsh M. Thaker ◽  
Daniel Eshtiaghpour ◽  
Raymond A. Addante ◽  
Stephen Kim ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
The Impact

scholarly journals Capsule Endoscopy in the Detection of Non-Small Bowel Lesions Missed by Endoscopy

2021 ◽  
Author(s):  
Carlo Calabrese ◽  
Dania Gelli ◽  
Nikolas Dussias ◽  
Laura Melotti ◽  
Giulia Peruzzi ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Patient Management ◽  
Care Center ◽  
Tertiary Care ◽  
Gi Endoscopy ◽  
Conventional Endoscopy ◽  
Registration Number ◽  
Management Changes ◽  
The Impact

Abstract Background and aims: Capsule endoscopy (CE) is indicated in cases with obscure gastrointestinal bleeding (OGIB). However, lesions detected by CE are frequently within the reach of conventional upper or lower GI endoscopy. We evaluated the accuracy of CE in the study of OGIB, examining the incidence of CE-detected non-small-bowel lesions (NSBL) missed by conventional endoscopy and studying its impact on patient management.Methods: We retrospectively analyzed 2010 CE procedures performed in a tertiary-care center (IBD-Unit Referral Centre in Bologna), comparing the findings on CE to those on prior colonoscopy and upper GI endoscopy performed within 3 months and two weeks of the CE procedure, respectively. We evaluated the impact of CE findings on patient management.Results: CE revealed abnormal findings in 1608 out of 2010 patients. Previously missed NSBLs were revealed on CE in 283 cases. Of these, 265 pre-CE endoscopic reports were found to not conform to reporting guidelines. NSBLs on CE led to management changes in 271 patients.Conclusion: This study confirms the utility of CE in patients with OGIB. However, in a considerable number of cases, CE identified lesions missed by conventional endoscopy, suggesting that a second look prior to CE may be appropriate in some patients.Name of registry and the registration number: The study protocol was approved by the Comitato Etico Indipendente dell’AOU di Bologna (n°173/2017/O/OssN)

scholarly journals Intraluminal Impact of Food: New Insights from MRI

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1147 ◽  
Author(s):  
Robin Spiller ◽  
Luca Marciani
Keyword(s):  
Small Bowel ◽  
Gastric Secretion ◽  
Water Content ◽  
Physical Factors ◽  
Non Invasive ◽  
Health And Disease ◽  
The Impact ◽  
Osmotic Effects ◽  
Serial Evaluation

Understanding how the gut responds to food has always been limited by the available investigatory techniques. Previous methods involving intubation and aspiration are largely limited to liquid-only meals. The aim of this review is to describe how MRI has allowed analysis of the processing of complex multiphase meals. This has demonstrated the role of physical factors such as viscosity, fat and fibre content in controlling gastric secretion and motility. It has also allowed the description of changes induced in small bowel water content and the role of osmotic effects of poorly absorbed carbohydrates such as fructose, sorbitol and mannitol. Intestinal secretions can be shown to be stimulated by a range of fruit and vegetables and the effect of this on colonic water content can also be measured. This has been used to demonstrate the mode of action of commonly used laxatives including bran and psyllium. The wealth of data which can be obtained together with its non-invasive nature and safety makes the technique ideal for the serial evaluation of the impact of different nutrients and drugs in both health and disease.

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