Song Hyun Joo, Moon Jeong Seop, Jeon Seong Ran, Kim Jin-Oh, Kim Jinsu, Cheung Dae Young, Choi Myung-Gyu, Lim Yun Jeong, Shim Ki-Nam, Ye Byong Duk, Cheon Jae Hee, Park Cheol Hee, Kim Hyun-Soo, Kim Ji Hyun, Chang Dong Kyung, Do Jae Hyuk, Kim Kyeong Ok, Jang Byung Ik, Shin Sung-Jae
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.
Gut Liver. 2017 Mar 15;11(2):253-260. doi: 10.5009/gnl16231.
BACKGROUND/AIMS: In some cases, chronic diarrhea is unexplained, and small bowel disorders may be one of the causes. The aim of this study was to assess the diagnostic yield and clinical impact of video capsule endoscopy (VCE) in patients with chronic diarrhea.
We retrospectively analyzed records from October 2002 to August 2013 in the VCE nationwide database registry (n=2,964). Ninety-one patients from 15 medical centers (60 males and 31 females; mean age, 47±19 years) were evaluated for VCE as a result of chronic diarrhea.
The duration of chronic diarrhea was 8.3±14.7 months. The positive diagnostic yield of VCE was 42.9% (39/91). However, 15.4% (14/91) exhibited an inconsistent result, and 41.8% (38/91) were negative. Abnormal findings consistent with chronic diarrhea included erosions/aphthous ulcers (19.8%), ulcers (17.6%), mucosal erythema (3.3%), edema (1.1%), and luminal narrowing (1.1%). The most common diagnoses were functional diarrhea associated with irritable bowel syndrome in 37 patients (40.7%) and Crohn's disease in 18 patients (19.8%). After VCE examination, the diagnosis was changed in 34.1% of the patients (31/91). Hematochezia (odds ratio [OR], 8.802; 95% confidence interval [CI], 2.126 to 36.441) and hypoalbuminemia (OR, 4.811; 95% CI, 1.241 to 18.655) are predictive factors of a positive diagnostic yield.
VCE had a favorable diagnostic yield and clinical impact on the management of patients with chronic diarrhea.
背景/目的：在某些情况下，慢性腹泻病因不明，小肠疾病可能是原因之一。本研究旨在评估视频胶囊内镜（VCE）对慢性腹泻患者的诊断率及临床影响。
我们回顾性分析了2002年10月至2013年8月VCE全国数据库登记处的记录（n = 2,964）。来自15个医疗中心的91例患者（60例男性，31例女性；平均年龄47±19岁）因慢性腹泻接受了VCE评估。
慢性腹泻的病程为8.3±14.7个月。VCE的阳性诊断率为42.9%（39/91）。然而，15.4%（14/91）的结果不一致，41.8%（38/91）为阴性。与慢性腹泻一致的异常发现包括糜烂/阿弗他溃疡（19.8%）、溃疡（17.6%）、黏膜红斑（3.3%）、水肿（1.1%）和管腔狭窄（1.1%）。最常见的诊断是37例（40.7%）与肠易激综合征相关的功能性腹泻和18例（19.8%）克罗恩病。VCE检查后，34.1%的患者（31/91）诊断发生了改变。便血（比值比[OR]，8.802；95%置信区间[CI]，2.126至36.441）和低白蛋白血症（OR，4.811；95%CI，1.241至18.655）是阳性诊断率的预测因素。
VCE对慢性腹泻患者的管理具有良好的诊断率和临床影响。
