EHPnet: Painting a Healthier Picture

Background: Capsule endoscopy (CE) is a unique tool to visualize the mucosa of the small intestine. Chronic intestinal dysmotility (CID) is a group of rare disorders of gastrointestinal motility that often are complicated by bacterial overgrowth. The aim of this study was to determine the prevalence of small bowel mucosal abnormalities in patients with CID. We also studied the usefulness of CE in the diagnosis of intestinal dysmotility. Methods: We conducted a prospective study using CE in 18 patients; six with myopathic, 11 with neuropathic and one with indeterminate CID. A control group was used for comparison of small bowel transit. Results: Mucosal breaks (erosions and ulcerations) were found in 16/18 (89%) patients. The capsule reached the caecum in 11/18 (61%) patients with a median transit time of 346 minutes. In the control group the capsule reached the caecum in 29/36 (81%) cases with a median transit time of 241 minutes. The difference in transit time was not significant (p = 0.061) in this material. The capsule was retained in the stomach in 3/18 patients. None of the patients developed symptoms or signs of mechanical obstruction. Conclusion: A high frequency of mucosal breaks and signs of motility disturbances were seen in CID patients. CE is feasible for the examination of small bowel mucosa in patients with CID. The relevance of observed mucosal abnormalities in CID remains uncertain. Background Chronic intestinal dysmotility (CID) is a syndrome that is characterized by symptoms and signs of intestinal obstruction in the absence of a mechanical blockage [1]. CID is caused by abnormalities in the intestinal smooth muscle or the myenteric plexus, usually affecting selectively one of them [2]. The underlying pathology in CID is thus believed to comprise two major types: myopathic and neuropathic disorders, although they usually present with similar clinical manifestations [3]. There is considerable confusion regarding the nomenclature in gastrointestinal motility disorders. Patients with CID can also be divided into those with chronic intestinal pseudoobstruction (CIP) and those with enteric dysmotility (ED) [4]. At present the possible medical or surgical treatment for this complex and often debilitating syndrome is limited [1,5,6]. Published: 18 July 2007 BMC Gastroenterology 2007, 7:29 doi:10.1186/1471-230X-7-29 Received: 22 January 2007 Accepted: 18 July 2007 This article is available from: http://www.biomedcentral.com/1471-230X/7/29 © 2007 Hoog et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.