scholarly journals Comparing Colon Capsule Endoscopy To Colonoscopy; A Symptomatic Patient’s Perspective

2021 ◽  
Author(s):  
M Syafiq Ismail ◽  
Greg Murphy ◽  
Serhiy Semenov ◽  
Deirdre McNamara
Keyword(s):  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Diseases ◽  
Exact Test ◽  
Colon Capsule Endoscopy ◽  
Patient Reported ◽  
Proven Efficacy ◽  
And Gender ◽  
Gcs Score

Abstract Introduction:Colon Capsule Endoscopy (CCE) has proven efficacy in a variety of gastrointestinal diseases. Few studies have assessed patient-reported outcomes and preference between colonoscopy and CCE.Aims:To identify comfort scores and patient preferences between CCE and colonoscopy.Methods:Patients from our centre who had both a CCE and colonoscopy within a 12-month period were identified. We performed over-the-phone interviews focused on satisfaction, comfort, and overall preference with a 10-point Likert scale. Electronic records were reviewed; reported Modified-Gloucester-Comfort-Scale (GCS) score, sedation, bowel preparation and endoscopist grade were documented. Data was compared between procedures. A Fishers exact test was used to compare proportions and a Student t-test was used to compare means, a p < 0.05 was considered significant.Results:In all, 40 patients were identified, 57.5% (23/40) were female and the mean age was 48 years (24 – 78). All patients were referred for investigation of lower gastrointestinal symptoms as part of an ongoing study (1).There was a significance difference in mean comfort (9.2 vs 6.7, p<0.0001, 95% CI -3.51 to -1.44) but not satisfaction (8.3 vs 7.7, p=0.2, 95% CI -1.48 to 0.33) between CCE and colonoscopy. Main cause of dissatisfaction with CCE was bowel preparation and for colonoscopy was discomfort. Age and gender were not found to be variables. The correlation between GCS and patient reported values was weak (R = -0.28).Overall, 77.5% (31/40) of patients would prefer a CCE if they required further bowel investigation. Of these, 77.4% (24/31) preferred a CCE despite the potential need for follow-up colonoscopy.Conclusions:CCE has a high satisfaction rating (8.3 vs 7.7) and has a higher patient reported comfort rating (9.2 vs 6.7) than colonoscopy. Studies have confirmed CCE and colonoscopy have equivalent diagnostic yields. The majority of patients in our cohort prefer CCE to colonoscopy. CCE should be considered as an alternative to colonoscopy in selected individuals.

scholarly journals Usefulness of Castor Oil and Elobixibat and Lactulose and ascorbic Aid for Bowel Preparation for Colon Capsule Endoscopy-Initial examination

2021 ◽  
pp. 42
Author(s):  
Keyword(s):  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Emission Rate ◽  
Excretion Rate ◽  
Discharge Rate ◽  
Total Water ◽  
Initial Examination ◽  
National Health Insurance System ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

Colon capsule endoscopy was approved for reimbursement under the national health insurance system of Japan in 2014. However, the capsule excretion rate after recommended bowel preparation reportedly ranges from 70% to 90%, and administration of boosters is also necessary. The caster oil-based booster had an emission rate of 97%, but required a total water content of 3L. Considering whether it is possible to popularize colon capsule endoscopy by reducing the amount of water, including dialysis patients with water restrictions, we will consider whether the capsule discharge rate can be improved by combining new laxatives.

scholarly journals Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses

Endoscopy ◽  
2020 ◽  
Author(s):  
Tue Kjølhede ◽  
Anne Mette Ølholm ◽  
Lasse Kaalby ◽  
Kristian Kidholm ◽  
Niels Qvist ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Literature Search ◽  
Diagnostic Yield ◽  
Screening Programs ◽  
Crc Screening ◽  
Colon Capsule Endoscopy ◽  
Meta Analyses ◽  
Standard Colonoscopy

Abstract Background Colon capsule endoscopy (CCE) is a technology that might contribute to colorectal cancer (CRC) screening programs as a filter test between fecal immunochemical testing and standard colonoscopy. The aim was to systematically review the literature for studies investigating the diagnostic yield of second-generation CCE compared with standard colonoscopy. Methods A systematic literature search was performed in PubMed, Embase, and Web of Science. Study characteristics including quality of bowel preparation and completeness of CCE transits were extracted. Per-patient sensitivity and specificity were extracted for polyps (any size, ≥ 10 mm, ≥ 6 mm) and lesion characteristics. Meta-analyses of diagnostic yield were performed. Results The literature search revealed 1077 unique papers and 12 studies were included. Studies involved a total of 2199 patients, of whom 1898 were included in analyses. The rate of patients with adequate bowel preparation varied from 40 % to 100 %. The rates of complete CCE transit varied from 57 % to 100 %. Our meta-analyses demonstrated that mean (95 % confidence interval) sensitivity, specificity, and diagnostic odds ratio were: 0.85 (0.73–0.92), 0.85 (0.70–0.93), and 30.5 (16.2–57.2), respectively, for polyps of any size; 0.87 (0.82–0.90), 0.95 (0.92–0.97), and 136.0 (70.6–262.1), respectively, for polyps ≥ 10 mm; and 0.87 (0.83–0.90), 0.88 (0.75–0.95), and 51.1 (19.8–131.8), respectively, for polyps ≥ 6 mm. No serious adverse events were reported for CCE. Conclusion CCE had high sensitivity and specificity for per-patient polyps compared with standard colonoscopy However, the relatively high rate of incomplete investigations limits the application of CCE in a CRC screening setting.

Gastrointestinal adverse drug reaction profile of etanercept: real world data from patients and healthcare professionals

2021 ◽  
pp. jrheum.201373
Author(s):  
Jette A. van Lint ◽  
Naomi T. Jessurun ◽  
Sander W. Tas ◽  
Bart J.F. van den Bemt ◽  
Michael T. Nurmohamed ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Dose Adjustment ◽  
Early Recognition ◽  
Gastrointestinal Symptoms ◽  
Data Sources ◽  
Inflammatory Rheumatic Diseases ◽  
Real World Data ◽  
Exact Test ◽  
Patient Reported ◽  
Tnfα Inhibitor

Objective We aimed to describe the nature and frequency of gastrointestinal adverse drug reactions (GI-ADRs) of etanercept (ETN) using patient-reported and healthcare professional (HCP)-registered data and compared this frequency with the GI-ADR frequency of the widely used TNFα-inhibitor adalimumab. Methods Reported GI-ADRs of ETN for rheumatic diseases were collected from the Dutch Biologic Monitor and DREAM registries. We described the clinical course of GI-ADRs and compared the frequency with adalimumab in both data sources using a Fisher’s exact test. Results Out of 416 patients using ETN for inflammatory rheumatic diseases in the Dutch Biologic Monitor, 25 patients (6%) reported 36 GI-ADRs. In the DREAM registries 11 GI-ADRs were registered for 9 patients (2.3%), out of 399 patients using ETN, with an incidence of 7.14 per 1000 patient years. Most GI-ADRs concerned diarrhoea, nausea and abdominal pain. GI-ADRs led to ETN discontinuation in one patient (4%) and dose adjustment in four (16%) in the Dutch Biologic Monitor. Eight GI-ADRs (73%) led to ETN discontinuation in the DREAM registries. The frequency of GI-ADRs of ETN did not significantly differ from GI-ADRs of adalimumab in both data sources (Dutch Biologic Monitor: ETN 8.7% vs. ADA 5.3%, p=0.07; DREAM: ETN 2.8% vs. ADA 4.7%, p=0.16). Conclusion Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN associated GI-ADRs was comparable to the frequency of adalimumab associated GI-ADRs. Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication.

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