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Capsule endoscopy adequate for esophageal studies
NEW YORK (Reuters Health) - Capsule endoscopy to evaluate the esophagus is a reasonable alternative to conventional upper endoscopy in certain patients, according to Spanish researchers.
It is a "valuable non-invasive screening option in patients unable or unwilling to undergo standard endoscopy," lead investigator Dr. Andres Sanchez-Yague told Reuters Health.
Standard upper gastrointestinal endoscopy, in which a tube with a tiny camera on the tip is placed down the throat (esophagus) so the area can be visualized, is the preferred technique. However, the procedure is often poorly tolerated by patients, and the use of sedation carries addition risks and costs.
Capsule endoscopy, which has only been proven successful for small bowel studies, is well-tolerated and requires no sedation. The patient swallows a wireless capsule that functions as an endoscope, which is eventually excreted. Like the standard procedure, a data recorder, antenna and workstation are also used.
Sanchez-Yague and colleagues at Virgen Macarena University Hospital, Seville report on 30 consecutive capsule examinations carried out in 28 patients who had refused to undergo conventional endoscopy. The findings appear in the European Journal Gastroenterology and Hepatology.
Most patients had symptoms of chronic gastroesophageal reflux disease (GERD) and the remainder had cirrhosis and required screening for esophageal varices. Esophageal erosions were seen in 58 percent of the GERD patients and varices were detected in 80 percent of the cirrhosis patients.
The team concludes that "esophageal capsule endoscopy is an adequate alternative" to upper GI endoscopy in this setting.
Almost all patients found the capsule easy to swallow and characterized the procedure as comfortable and, if needed, all were prepared to repeat the procedure.
The capsule approach, Sanchez-Yague continued, "allows us to study some esophageal conditions and indicate appropriate treatment in some patients who would otherwise remain untreated."
"As a screening modality," he concluded, "it will also help us recommend further diagnostic or therapeutic measures in selected patients."
SOURCE: European Journal Gastroenterology and Hepatology, September 2006.
Reuters Health