Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation
Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation
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DOI：
10.1007/s10620-011-1751-6
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发表时间：
2011-10-01
影响因子：
3.1
通讯作者：
Hasler, William L.
中科院分区：
文献类型：
--
作者：
Kuo, Braden;Maneerattanaporn, Monthira;Hasler, William L.
广泛性转运延迟的患病率及其与疑似胃轻瘫、肠蠕动障碍或慢转运便秘的症状的关系尚不清楚。本研究的目的是：(1)使用无线运动胶囊（WMC）确定广泛性运动障碍的患病率，(2)与疑似区域延迟的症状有关，(3)将WMC测试结果与常规运输研究进行比较，以量化新的诊断，(4)评估WMC测试结果对临床决策的影响。我们分析了83例疑似胃轻瘫、肠蠕动障碍或慢速转运便秘患者的WMC转运。32%（胃9%，小肠5%，结肠18%）观察到孤立的区域性延迟。32%的过境是正常的，35%的过境有广泛的延迟。症状与正常转运、孤立的胃、小肠和结肠转运延迟以及全面性转运延迟相似（P = NS）。与常规检查相比，38%的WMC显示不一致，53%的WMC提供新诊断。WMC检测对管理有67%的影响（新药物60%；改良营养方案14%；外科转诊6%），并消除了尚未完成的检测需求，包括胃显像（17%）、小肠钡转运（54%）和放射性不透明结肠标记物检测（68%）。WMC检测定义了局部和全身性运输延迟，疑似胃轻瘫、肠道蠕动障碍或缓慢运输便秘。症状不能预测WMC测试的结果。WMC的发现提供了bb50 %的新诊断，可能与常规检查不一致，并且可以通过改变治疗和消除其他检查的需要来影响管理。这些发现表明该方法在疑似运动障碍综合征中的潜在益处，并要求进行前瞻性研究以进一步确定其临床作用。
The prevalence of generalized transit delay and relation to symptoms in suspected gastroparesis, intestinal dysmotility, or slow transit constipation are unknown.The aims of this study were (1) to define prevalence of generalized dysmotility using wireless motility capsules (WMC), (2) to relate to symptoms in suspected regional delay, (3) to compare results of WMC testing to conventional transit studies to quantify new diagnoses, and (4) to assess the impact of results of WMC testing on clinical decisions.WMC transits were analyzed in 83 patients with suspected gastroparesis, intestinal dysmotility, or slow transit constipation.Isolated regional delays were observed in 32% (9% stomach, 5% small bowel, 18% colon). Transits were normal in 32% and showed generalized delays in 35%. Symptom profiles were similar with normal transit, isolated delayed gastric, small intestinal, and colonic transit, and generalized delay (P = NS). Compared to conventional tests, WMC showed discordance in 38% and provided new diagnoses in 53%. WMC testing influenced management in 67% (new medications 60%; modified nutritional regimens 14%; surgical referrals 6%) and eliminated needs for testing not already done including gastric scintigraphy (17%), small bowel barium transit (54%), and radioopaque colon marker tests (68%).WMC testing defines localized and generalized transit delays with suspected gastroparesis, intestinal dysmotility, or slow transit constipation. Symptoms do not predict the results of WMC testing. WMC findings provide new diagnoses in > 50%, may be discordant with conventional tests, and can influence management by changing treatments and eliminating needs for other tests. These findings suggest potential benefits of this method in suspected dysmotility syndromes and mandate prospective investigation to further define its clinical role.