Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: A Greek multicenter study

Abstract Background Wireless capsule endoscopy has become the gold standard for the examination of small bowel. However, its role in the evaluation of patients suffering from chronic abdominal pain is not yet clearly defined. We conducted an open-label prospective multi-center study to evaluate the...

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Published in:	European journal of internal medicine Vol. 22; no. 5; pp. e63 - e66
Main Authors:	Katsinelos, Panagiotis, Fasoulas, Kostas, Beltsis, Athanasios, Chatzimavroudis, Grigoris, Paroutoglou, George, Maris, Theofanis, Mimidis, Kostas, Koufokotsios, Alexandros, Terzoudis, Sotiris, Atmatzidis, Stefanos, Kaltsa, Agoritsa, Kapetanos, Dimitris, Kamperis, Eustathios, Zavos, Christos, Kountouras, Jannis, Belou, Aristea
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-10-2011
Subjects:	Abdominal pain Abdominal Pain - diagnosis Abdominal Pain - epidemiology Abdominal Pain - etiology Adolescent Adult Aged Aged, 80 and over Capsule endoscopy Capsule Endoscopy - methods Chronic Pain - diagnosis Chronic Pain - epidemiology Chronic Pain - etiology Diagnosis, Differential Diarrhea Diarrhea - complications Diarrhea - diagnosis Diarrhea - epidemiology Female Follow-Up Studies Greece - epidemiology Humans Incidence Internal Medicine Intestine, Small - pathology Male Middle Aged Prospective Studies Reproducibility of Results Young Adult Greece Abdominal pain Diarrhea Capsule endoscopy
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Summary:	Abstract Background Wireless capsule endoscopy has become the gold standard for the examination of small bowel. However, its role in the evaluation of patients suffering from chronic abdominal pain is not yet clearly defined. We conducted an open-label prospective multi-center study to evaluate the yield and clinical outcome of capsule endoscopy in patients with chronic abdominal pain with/without diarrhea. Methods Seventy-two patients with chronic (> 3 months) abdominal pain with/without diarrhea in whom the underlying pathology could not be diagnosed by conventional modalities, underwent capsule endoscopy in either of the 6 participating centers. Patients were then followed up for clinical outcomes. Results The overall diagnostic yield of capsule endoscopy was 44.4%. More specifically, its diagnostic yield was 21.4% in patients with abdominal pain and negative inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), 66.7% in patients with abdominal pain and positive inflammatory markers, 0% in patients with abdominal pain, diarrhea and negative inflammatory markers, and 90.1% in patients with abdominal pain, diarrhea and positive inflammatory markers. Both univariate and multivariate regression analyses showed that abnormal C-reactive protein and erythrocyte sedimentation rate were significant factors related with positive capsule endoscopy findings. Conclusions Chronic abdominal pain with/without diarrhea should be accompanied by elevated inflammatory markers to be regarded as a valid indication for capsule endoscopy. The yield of capsule endoscopy in such patients is reasonably high and clinical outcomes of patients treated with capsule endoscopy findings as a guide are significant.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0953-6205 1879-0828
DOI:	10.1016/j.ejim.2011.06.012