Yung Diana, Douglas Sarah, Hobson Anthony R, Giannakou Andry, Plevris John N, Koulaouzidis Anastasios
Royal Infirmary of Edinburgh - Centre of Liver & Digestive Disorders, Edinburgh, UK.
The Functional Gut Clinic - The Functional Gut Clinic, London, UK.
Endosc Int Open. 2016 Apr;4(4):E480-6. doi: 10.1055/s-0042-100718. Epub 2016 Mar 22.
SmartPill(®) (Given Imaging Corp.,Yoqneam,Israel) is an ingestible, non-imaging capsule that records physiological data including contractions and pH throughout the gastrointestinal tract. There are scarce data looking at SmartPill(®) assessment of patients with known/suspected small-bowel Crohn's Disease (CD). This pilot study aims to investigate feasibility and safety of SmartPill(®) to assess gut motility in this group.
Over 1 year, patients with known/suspected CD, referred for small-bowel capsule endoscopy (SBCE), were invited to participate and 12 were recruited (7 female, 5 male, mean age 44.2 ± 16.6 years). They underwent hydrogen breath test to exclude small-bowel bacterial overgrowth, patency capsule (Agile(®)), and provided stool samples for fecal calprotectin (FC). Patients ingested PillCam(®)SB2 and SmartPill(®) 4 hours apart. Using unpublished data, 33 healthy controls also were identified for the study. P < 0.05 was considered statistically significant.
Of the 12 patients enrolled, 10 underwent complete Smartpill(®) examination (1 stomach retention, 1 dropout). Pillcam(®) was complete in 10 (1 dropout, 1 stomach retention). Mean fecal calprotectin was 340 ± 307.71 mcg/g. The study group had longer transit times and lower gut motility index than did the controls. The difference in motility appears to be statistically significant (P < 0.05). Longer transit times for SmartPill(®) (not statistically significant) may have been due to different specifications between the capsules. Limitations included transient Smartpill(®) signal loss (5/10 studies).
This is the first pilot to attempt combining SBCE and SmartPill(®) to assess small-bowel CD. Data on motility in CD are scarce. Multimodal information can provide a clearer clinical picture. Despite concerns about capsule retention in CD patients, SmartPill(®) seems safe for use if a patency capsule is employed beforehand.
SmartPill（®）（以色列约纳姆的Given Imaging公司）是一种可吞咽的非成像胶囊，可记录整个胃肠道的生理数据，包括收缩和pH值。关于SmartPill（®）对已知/疑似小肠克罗恩病（CD）患者评估的数据很少。这项初步研究旨在调查SmartPill（®）评估该组患者肠道动力的可行性和安全性。
在1年多的时间里，邀请因小肠胶囊内镜检查（SBCE）前来就诊的已知/疑似CD患者参与研究，招募了12名患者（7名女性，5名男性，平均年龄44.2±16.6岁）。他们接受了氢呼气试验以排除小肠细菌过度生长，吞服了通畅胶囊（Agile（®）），并提供粪便样本用于检测粪便钙卫蛋白（FC）。患者在相隔4小时的时间分别吞服PillCam（®）SB2和SmartPill（®）。利用未发表的数据，还确定了33名健康对照者参与该研究。P<0.05被认为具有统计学意义。
在纳入的12名患者中，10名完成了Smartpill（®）检查（1例胃潴留，1例退出）。10名患者完成了Pillcam（®）检查（1例退出，1例胃潴留）。粪便钙卫蛋白平均水平为340±307.71 mcg/g。研究组的转运时间比对照组更长，肠道动力指数更低。动力方面的差异似乎具有统计学意义（P<0.05）。SmartPill（®）转运时间较长（无统计学意义）可能是由于胶囊之间的规格不同。局限性包括Smartpill（®）信号短暂丢失（10项研究中有5项）。
这是首次尝试将SBCE和SmartPill（®）结合起来评估小肠CD的初步研究。关于CD患者肠道动力的数据很少。多模式信息可以提供更清晰的临床情况。尽管担心CD患者会出现胶囊滞留，但如果事先使用通畅胶囊，SmartPill（®）似乎可以安全使用。
