The Relationship between Physical Activity Level and Completion Rate of Small Bowel Examination in Patients Undergoing Capsule Endoscopy

Tomoyoshi Shibuya; Hiroki Mori; Tsutomu Takeda; Masae Konishi; Yuka Fukuo; Kenshi Matsumoto; Kazuko Beppu; Naoto Sakamoto; Taro Osada; Akihito Nagahara; Michiro Otaka; Tatsuo Ogihara; Sumio Watanabe

doi:10.2169/internalmedicine.51.6581

ORIGINAL ARTICLES

The Relationship between Physical Activity Level and Completion Rate of Small Bowel Examination in Patients Undergoing Capsule Endoscopy

Tomoyoshi Shibuya, Hiroki Mori, Tsutomu Takeda, Masae Konishi, Yuka Fukuo, Kenshi Matsumoto, Kazuko Beppu, Naoto Sakamoto, Taro Osada, Akihito Nagahara, Michiro Otaka, Tatsuo Ogihara, Sumio Watanabe

Author information

Tomoyoshi Shibuya
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Hiroki Mori
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Tsutomu Takeda
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Masae Konishi
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Yuka Fukuo
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Kenshi Matsumoto
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Kazuko Beppu
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Naoto Sakamoto
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Taro Osada
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Akihito Nagahara
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Michiro Otaka
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Tatsuo Ogihara
Department of Gastroenterology, Juntendo University School of Medicine, Japan
Sumio Watanabe
Department of Gastroenterology, Juntendo University School of Medicine, Japan

Keywords: capsule endoscopy, completion rate, physical activity, bed rest, multivariate logistic regression analysis

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 9 Pages 997-1001

DOI https://doi.org/10.2169/internalmedicine.51.6581

Details

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.
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).
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).
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.

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