Goals: To examine the diagnostic utility of wireless motility capsule (WMC) in patients with suspected gastrointestinal (GI) dysmotility.
Background: Subjects with suspected GI motility disorders undergo invasive and expensive diagnostic tests. In these patients, whether WMC provides clinically useful information is unknown.
Study: Patients with symptoms of dysmotility and normal endoscopic/radiologic evaluations were assessed with WMC test and conventional motility tests (CMT). Diagnostic utility of WMC was assessed retrospectively by examining device agreement and new information compared with CMT.
Results: On the basis of predominant symptom(s), 86 patients were classified into 2 subgroups: lower GI (LGI=50) and upper GI (UGI=36). Clinical suspicion was confirmed in 52% and 66% of patients, respectively, and there was good device agreement between WMC and CMT in 76% and 81% in the LGI and UGI groups, respectively. There was new diagnostic information with the WMC test in 53% of the LGI (P=0.006) and 47% of the UGI group (P=0.001). WMC detected generalized motility disorder in 44 (51%) patients and influenced management in 30% of LGI and 50% of UGI subjects.
Conclusions: WMC confirmed clinical suspicion, provided new diagnostic information, influenced clinical management, and detected many patients with generalized motility disorder. It had good device agreement with conventional tests.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Dr Satish S. C. Rao is supported by NIH grant No. 2R01 KD57100-05A2. Portions of this manuscript were presented at DDW in New Orleans, 2010 and published as an abstract in Gastroenterology 2010;138:S1344.
Declaration of personal/financial interests: Dr Rao serves as an advisory board member and has received research funding from the SmartPill Corporation. Dr Ashok Attaluri, Dr Krupa Mysore, and Jessica Valestin have nothing to disclose.
Reprints: Satish S.C. Rao, MD, PhD, FRCP (LON), 4612 JCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1009 (e-mail: firstname.lastname@example.org).
Received June 28, 2010
Accepted September 24, 2010