Clinical utility of wireless motility capsule in patients with suspected multiregional gastrointestinal dysmotility

Abstract

Background: Patients with gastrointestinal (GI) dysmotility often experience overlapping upper and lower GI symptoms suggestive of multiregional involvement. Wireless motility capsule (WMC) provides a full GI tract transit profile and may be able to detect and diagnose multiregional dysmotility.

Aim: To determine the clinical utility and diagnostic yield of WMC in patients with upper and lower GI symptoms suggestive of multiregional GI dysmotility.

Methods: Retrospective chart review of all patients who had undergone WMC testing for suspected multiregional GI dysmotility from January 2009 to December 2012 at our institution was performed. Information regarding demographics, symptoms, medication use, prior diagnostic studies, and results of WMC testing was collected.

Results: A total of 161 patients were included in the analysis. Mean age was 43 ± 15 years, and 83 % were female. WMC was abnormal in 109 (67.7 %) subjects. Of these, 17 (15.6 %) patients had isolated delayed gastric emptying, 13 (11.9 %) patients had isolated delayed small bowel transit, and 25 (22.9 %) patients had isolated delayed large bowel transit. Multiregional dysmotility was diagnosed in 54 (49.5 %) patients. There was no significant difference in past medical or past surgical history between patients with isolated regional versus multiregional involvement. The presence or absence of various patient-reported symptoms by history did not predict an abnormal WMC study.

Conclusions: Patients' symptoms are poor predictors of GI dysmotility and its anatomical extent. WMC can be a useful diagnostic test in these patients as it provides a comprehensive evaluation of the motility profile of the entire GI tract and provides objective evidence of multiregional involvement.