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. 2021 Nov 16;11(11):2123.
doi: 10.3390/diagnostics11112123.

Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis

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Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis

Wonshik Kim et al. Diagnostics (Basel). .

Abstract

Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture (n = 14, 60.9%) and erosion (n = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02-1.1, p = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81-70.60; p = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92-227.33; p = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP.

Keywords: chronic abdominal pain; inflammatory markers; video capsule endoscopy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart showing patient inclusion.
Figure 2
Figure 2
Preferred reporting items for systematic reviews and meta-analyses diagram.
Figure 3
Figure 3
The area under the ROC curve for ESR for predicting a positive finding of VCE in patients with CAP was 0.69 (95% CI 0.57–0.80). ROC, Receiver operating characteristics; CI, confidence interval.
Figure 4
Figure 4
(A) forest plot of elevated ESR; (B) funnel plots of studies that examined elevated ESR; (C) forest plot of elevated CRP; (D) funnel plots of studies that examined elevated CRP.

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