Initial studies on esophageal capsule endoscopy reported excellent sensitivity and specificity.
However, these were followed by mixed results in several subsequent studies.
The mixed results were probably due to deviations from the recommended ingestion protocol and the inconvenience of capsule ingestion in the supine position.
Dr Gralnek and colleagues from Israel tested a simplified ingestion procedure for esophageal capsule endoscopy.
The investigative team used a cross-over study design in 24 health volunteers, of which 9 were women with a mean age of 44.
The simplified ingestion procedure was prospectively compared with the original ingestion procedure for esophageal capsule endoscopy.
|There was less interference of bubbles or saliva at the gastroesophageal junction|
The investigators evaluated for bubbles or saliva interference at the Z-line, Z-line circumferential visualization, and convenience and ease of the ingestion procedure.
All Rapid 4 videos were reviewed in a randomized manner and read by an experienced esophageal capsule endoscopy reader blinded to the ingestion procedure used.
The investigative team found that the simplified ingestion procedure significantly improved visualization in comparison with the original ingestion procedure.
There was less interference due to bubbles or saliva observed at the gastroesophageal junction, and improved visualization of the Z-line.
Although the esophageal transit time was significantly faster with the simplified ingestion procedure, the team found no differences in the number of Z-line frames/images captured.
Dr Gralnek's team concludes, “This new, simplified ingestion procedure for esophageal capsule endoscopy provides significantly improved visualization of the Z-line in healthy volunteers.”
“The overall test characteristics of esophageal capsule endoscopy using simplified ingestion procedure should be tested in patients with esophageal disease.”