The Antro-pyloric Capsular Movement by Capsule Endoscopy

Abstract

Background/Aims: Capsule endoscopy (CE) is used for various purposes. The aims of this study were to classify the types of antro-pyloric capsular movement in CE and to investigate the relationship between the types of capsular movement and clinical factors, including gastric emptying time (GET). Methods: Out of 103 patients who received CE between January 2004 and July 2006, 82 patients (33 female, mean age of 50.6 years) were retrospectively analyzed for capsular movement; 21 patients were excluded because of the history of medications and previous surgeries. CE images were interpreted by a single investigator in relation to the GET and types of antro-pyloric capsular movement. Results: Antro-pyloric capsular movement was classified into four patterns: type 1, large longitudinal to-and-fro movements in the antrum followed by passage through the pylorus without resistance; type 2, after large longitudinal to-and-fro movements, passage through the pylorus with resistance (> 1 minute); type 3, mixed pattern of type 1 and 4; type 4, weak movement. Median GET by CE were 14.1 minutes (range, 1.2-50.1), 21.7 minutes (6.2-154.9), 57.3 minutes (14.9-249.8), and 58.8 minutes (21.0-249.5) for type 1, 2, 3, and 4, respectively. GET in type 1 and 2 were significantly shorter than that in type 3 and 4 (p < 0.05). Ten diabetic patients presented with type 2 (n = 5), 3 (n = 3), and 4 (n = 2) patterns, but not with type 1. Conclusions: Our results suggest the analysis of capsule movement using CE to be a possible method of evaluating the antro-pyloric movement. (J Neurogastroenterol Motil 2010;16:172-176)