Introduction The completion rate of small bowel capsule endoscopy (SBCE) has been reported as 81.3–84.8%.1 Aside lumenal narrowing, incomplete SBCE can be due to delayed gastric emptying, intestinal dysmotility and/or capsule battery life. Prokinetic agents are used to increase completion rate (CR) and theoretically diagnostic yield. Domperidone, an antidopaminergic agent, has not been widely used in SBCE; 2,3 unlike Metoclopramide, it lacks extrapyramidal adverse effects.
Methods Retrospective study; to assess gastric transit time (GTT), small-bowel transit time (SBTT) and the CR of SBCE when using domperidone. Furthermore, we aimed to compare the CR of 2 different SBCE systems (MiroCam®,PillCam®). Consecutive SBCE examinations (period 2008–2012) from a tertiary referral centre in Scotland were analysed; domperidone was not administered to the first 203 patients, but was given orally to the subsequent 449, reflecting changes in clinical practise.
Results In the aforementioned period, a total of 652 SBCE examinations were performed [265 (40.6%) men and 387 (59.4%) women]; 385/652 (59%) were performed with PillCam® and 267 (41%) with Mirocam®. The most common indications for SBCE were obscure gastrointestinal bleeding, anaemia, Crohn’s disease (known or suspected) and abdominal pain. In 449/652 (68.9%) liquid domperidone (5 mg) was administered for capsule ingestion, while in 203 (31.1%) the capsule was ingested without any domperidone.
In our series, the overall CR of SBCE was 86.7%. The 2 SBCE systems showed equivalent CR (PillCam® 87.5%, MiroCam® 85.4%; P = 0.43). The use of domperidone increased CR (88.6% vs 82.3%, P = 0.027). A higher CR was noted when domperidone was used with PillCam® in contrast to MiroCam® (82.2 vs 92.5%, P = 0.002 and 83.3 vs 85.5% respectively, P = 0.8). Furthermore, the median GTT and the median SBTT did not differ between the two groups (GTT/SBTT with Domperidone 27.0’/222.0’ and without 30.5’/228.0’, respectively; P = 0.436/P = 0.477).The median age of patients who received domperidone was higher compared with patients who did not receive (58y vs 48y, P = 0.009), although CR was not affected by the age (complete: 55 y, incomplete: 61 y, P = 0.331).
Conclusion The use of Domperidone increases the CR of SBCE with PillCam®, although it does not affect the GTT and SBTT and should be routinely used to improve CR in SBCE with PillCam®.
Disclosure of Interest S. Dimitriadis: None Declared, A. Koulaouzidis Grant/Research Support from: Given Imaging Ltd, S. Douglas: None Declared, J. Plevris: None Declared
Liao Z, et al. Indications and detection, completion and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc 2010; 71:280–6.
Westerhof J, et al. Diagnostic yield of small-bowel capsule endoscopy depends on the small-bowel transit time. World J Gastroenterol 2012; 18:1502–07.
Keuchel M, et al. Domperidone shortens gastric transit time of video capsule endoscope. Endoscopy 2003; 35(Suppl. II):A185.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.