Tags

Type your tag names separated by a space and hit enter

Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study).
Endoscopy. 2007 Jul; 39(7):606-12.E

Abstract

BACKGROUND

On the basis of the published data, capsule endoscopy cannot be recommended in patients whose only symptom is chronic abdominal pain. The present study therefore focused on the diagnostic yield of capsule endoscopy in patients with chronic abdominal pain who were also suffering from additional symptoms.

PATIENTS AND METHODS

A total of 50 patients with chronic abdominal pain, plus other symptoms singly or in combination were enrolled in this prospective multicenter trial. The "plus" symptoms or signs consisted of weight loss (> 10 % of body weight), inflammation shown by laboratory tests, chronic anemia, or suspected mid-gastrointestinal bleeding. Chronic diarrhea was recorded if present, but patients did not qualify for the study if they had pain and diarrhea alone. Capsule endoscopy was carried out following a defined previous diagnostic work-up that had not revealed the cause of the patient's symptoms. The capsule videos were assessed by two independent blinded investigators. The findings were classified as relevant, potentially relevant, or not relevant for explaining the symptoms, or else classified as normal.

RESULTS

The capsule reached the cecum in 84 % of the patients (42 of 50). Relevant findings were discovered on capsule endoscopy in 36 % and 40 % of patients by the two investigators, and potentially relevant findings in 14 % and 24 % of patients. The additional symptom or sign of inflammation was associated with the highest diagnostic yield (odds ratio 3.2). The presence of more than one additional symptom did not increase the yield in our patient group. Two capsules (4 %) entrapped at previously unrecognized stenoses were removed endoscopically using push-and-pull enteroscopy (n = 1) or surgery (n = 1).

CONCLUSIONS

Strict patient selection on the basis of additional symptoms or signs is the key to increasing the yield of capsule endoscopy in patients with chronic abdominal pain. Inflammation seemed to be the additional sign with the highest value.

Authors+Show Affiliations

Department of Medicine II, HSK Wiesbaden (Teaching Hospital of the University of Mainz), Wiesbaden, Germany. ADinahMay@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

17611915

Citation

May, A, et al. "Prospective Multicenter Trial of Capsule Endoscopy in Patients With Chronic Abdominal Pain, Diarrhea and Other Signs and Symptoms (CEDAP-Plus Study)." Endoscopy, vol. 39, no. 7, 2007, pp. 606-12.
May A, Manner H, Schneider M, et al. Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study). Endoscopy. 2007;39(7):606-12.
May, A., Manner, H., Schneider, M., Ipsen, A., & Ell, C. (2007). Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study). Endoscopy, 39(7), 606-12.
May A, et al. Prospective Multicenter Trial of Capsule Endoscopy in Patients With Chronic Abdominal Pain, Diarrhea and Other Signs and Symptoms (CEDAP-Plus Study). Endoscopy. 2007;39(7):606-12. PubMed PMID: 17611915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study). AU - May,A, AU - Manner,H, AU - Schneider,M, AU - Ipsen,A, AU - Ell,C, PY - 2007/7/6/pubmed PY - 2007/9/21/medline PY - 2007/7/6/entrez SP - 606 EP - 12 JF - Endoscopy JO - Endoscopy VL - 39 IS - 7 N2 - BACKGROUND: On the basis of the published data, capsule endoscopy cannot be recommended in patients whose only symptom is chronic abdominal pain. The present study therefore focused on the diagnostic yield of capsule endoscopy in patients with chronic abdominal pain who were also suffering from additional symptoms. PATIENTS AND METHODS: A total of 50 patients with chronic abdominal pain, plus other symptoms singly or in combination were enrolled in this prospective multicenter trial. The "plus" symptoms or signs consisted of weight loss (> 10 % of body weight), inflammation shown by laboratory tests, chronic anemia, or suspected mid-gastrointestinal bleeding. Chronic diarrhea was recorded if present, but patients did not qualify for the study if they had pain and diarrhea alone. Capsule endoscopy was carried out following a defined previous diagnostic work-up that had not revealed the cause of the patient's symptoms. The capsule videos were assessed by two independent blinded investigators. The findings were classified as relevant, potentially relevant, or not relevant for explaining the symptoms, or else classified as normal. RESULTS: The capsule reached the cecum in 84 % of the patients (42 of 50). Relevant findings were discovered on capsule endoscopy in 36 % and 40 % of patients by the two investigators, and potentially relevant findings in 14 % and 24 % of patients. The additional symptom or sign of inflammation was associated with the highest diagnostic yield (odds ratio 3.2). The presence of more than one additional symptom did not increase the yield in our patient group. Two capsules (4 %) entrapped at previously unrecognized stenoses were removed endoscopically using push-and-pull enteroscopy (n = 1) or surgery (n = 1). CONCLUSIONS: Strict patient selection on the basis of additional symptoms or signs is the key to increasing the yield of capsule endoscopy in patients with chronic abdominal pain. Inflammation seemed to be the additional sign with the highest value. SN - 1438-8812 UR - https://www.unboundmedicine.com/medline/citation/17611915/Prospective_multicenter_trial_of_capsule_endoscopy_in_patients_with_chronic_abdominal_pain_diarrhea_and_other_signs_and_symptoms__CEDAP_Plus_Study__ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-966640 DB - PRIME DP - Unbound Medicine ER -