Investigation of Colonic and Whole-Gut Transit With Wireless Motility Capsule and Radiopaque Markers in Constipation

Satish Sanku Chander Rao, Braden Kuo, Richard W. McCallum, William D. Chey, John K. DiBaise, William L. Hasler, Kenneth L. Koch, Jeffrey M. Lackner, Carrie Miller, Richard Saad, Jack R. Semler, Michael D. Sitrin, Gregory E. Wilding, Henry P. Parkman

Research output: Contribution to journalArticle

192 Citations (Scopus)

Abstract

Background & Aims: Colonic transit time (CTT) traditionally is assessed with radiopaque markers (ROMs), which requires radiation and is hindered by lack of standardization and compliance. We assessed regional and CTT with the SmartPill (SmartPill Corporation, Buffalo, NY), a new wireless pH and pressure recording capsule, in constipated and healthy subjects and compared this with ROM. Methods: Seventy-eight constipated (Rome II) and 87 healthy subjects ingested a 260-kcal meal, a ROM capsule, and the SmartPill. Subjects wore a data receiver and kept daily stool diaries for 5 days. SmartPill recordings assessed CTT, whole-gut transit time (WGTT), small-bowel transit time, and gastric emptying time. Abdominal radiographs on days 2 and 5 assessed ROM transit. Sensitivity/specificity and receiver operating characteristics (ROCs) of each technique and utility were compared. Results: Gastric emptying time, CTT, and WGTT were slower (P < .01) in constipated subjects than controls. CTT was slower in women than men (P = .02). Day 2 and day 5 ROM transits were slower (P < .001) in constipated subjects. Correlation of the SmartPill CTT with ROMs expelled on day 2/day 5 was r = 0.74/r = 0.69 in constipation, and r = 0.70/r = 0.40 in controls, respectively. The diagnostic accuracy of the SmartPill CTT to predict constipation from ROC was 0.73, with a specificity of 0.95. These were comparable with those of day 5 ROM (ROC, 0.71; specificity, 0.95). Conclusions: The SmartPill is a novel ambulatory technique of assessing regional (gastric, small bowel, colonic) and WGTT without radiation. It reveals hitherto unrecognized gender differences and upper-gut dysfunction in constipation. It correlates well with ROM and offers a standardized method of discriminating normal from slow colonic transit.

Original languageEnglish (US)
Pages (from-to)537-544
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume7
Issue number5
DOIs
StatePublished - May 1 2009
Externally publishedYes

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Constipation
Capsules
ROC Curve
Gastric Emptying
Healthy Volunteers
Radiation
Buffaloes
Compliance
Meals
Stomach

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Investigation of Colonic and Whole-Gut Transit With Wireless Motility Capsule and Radiopaque Markers in Constipation. / Rao, Satish Sanku Chander; Kuo, Braden; McCallum, Richard W.; Chey, William D.; DiBaise, John K.; Hasler, William L.; Koch, Kenneth L.; Lackner, Jeffrey M.; Miller, Carrie; Saad, Richard; Semler, Jack R.; Sitrin, Michael D.; Wilding, Gregory E.; Parkman, Henry P.

In: Clinical Gastroenterology and Hepatology, Vol. 7, No. 5, 01.05.2009, p. 537-544.

Research output: Contribution to journalArticle

Rao, SSC, Kuo, B, McCallum, RW, Chey, WD, DiBaise, JK, Hasler, WL, Koch, KL, Lackner, JM, Miller, C, Saad, R, Semler, JR, Sitrin, MD, Wilding, GE & Parkman, HP 2009, 'Investigation of Colonic and Whole-Gut Transit With Wireless Motility Capsule and Radiopaque Markers in Constipation', Clinical Gastroenterology and Hepatology, vol. 7, no. 5, pp. 537-544. https://doi.org/10.1016/j.cgh.2009.01.017
Rao, Satish Sanku Chander ; Kuo, Braden ; McCallum, Richard W. ; Chey, William D. ; DiBaise, John K. ; Hasler, William L. ; Koch, Kenneth L. ; Lackner, Jeffrey M. ; Miller, Carrie ; Saad, Richard ; Semler, Jack R. ; Sitrin, Michael D. ; Wilding, Gregory E. ; Parkman, Henry P. / Investigation of Colonic and Whole-Gut Transit With Wireless Motility Capsule and Radiopaque Markers in Constipation. In: Clinical Gastroenterology and Hepatology. 2009 ; Vol. 7, No. 5. pp. 537-544.
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AU - Rao, Satish Sanku Chander

AU - Kuo, Braden

AU - McCallum, Richard W.

AU - Chey, William D.

AU - DiBaise, John K.

AU - Hasler, William L.

AU - Koch, Kenneth L.

AU - Lackner, Jeffrey M.

AU - Miller, Carrie

AU - Saad, Richard

AU - Semler, Jack R.

AU - Sitrin, Michael D.

AU - Wilding, Gregory E.

AU - Parkman, Henry P.

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N2 - Background & Aims: Colonic transit time (CTT) traditionally is assessed with radiopaque markers (ROMs), which requires radiation and is hindered by lack of standardization and compliance. We assessed regional and CTT with the SmartPill (SmartPill Corporation, Buffalo, NY), a new wireless pH and pressure recording capsule, in constipated and healthy subjects and compared this with ROM. Methods: Seventy-eight constipated (Rome II) and 87 healthy subjects ingested a 260-kcal meal, a ROM capsule, and the SmartPill. Subjects wore a data receiver and kept daily stool diaries for 5 days. SmartPill recordings assessed CTT, whole-gut transit time (WGTT), small-bowel transit time, and gastric emptying time. Abdominal radiographs on days 2 and 5 assessed ROM transit. Sensitivity/specificity and receiver operating characteristics (ROCs) of each technique and utility were compared. Results: Gastric emptying time, CTT, and WGTT were slower (P < .01) in constipated subjects than controls. CTT was slower in women than men (P = .02). Day 2 and day 5 ROM transits were slower (P < .001) in constipated subjects. Correlation of the SmartPill CTT with ROMs expelled on day 2/day 5 was r = 0.74/r = 0.69 in constipation, and r = 0.70/r = 0.40 in controls, respectively. The diagnostic accuracy of the SmartPill CTT to predict constipation from ROC was 0.73, with a specificity of 0.95. These were comparable with those of day 5 ROM (ROC, 0.71; specificity, 0.95). Conclusions: The SmartPill is a novel ambulatory technique of assessing regional (gastric, small bowel, colonic) and WGTT without radiation. It reveals hitherto unrecognized gender differences and upper-gut dysfunction in constipation. It correlates well with ROM and offers a standardized method of discriminating normal from slow colonic transit.

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