Initial experience of real-time capsule endoscopy in monitoring progress of the videocapsule through the upper GI tract.

BACKGROUND Wireless capsule endoscopy (WCE) is one of the most important investigations for small bowel examination. Although newer-generation WCE is equipped with a real-time viewer, the role of this advancement in daily practice remains unknown. OBJECTIVE Our purpose was to determine the role of the real-time viewer for monitoring of the videoendoscope passage through the upper GI tract. DESIGN Case-control comparison. SETTING Single tertiary referral center. PATIENTS Forty-five consecutive patients who underwent capsule endoscopy in a 12-month period were studied. Twenty-seven patients received conventional WCE, whereas 18 patients were examined by real-time WCE. Passage into the small bowel was monitored with the real-time viewer in the second group of patients. Gastric transit time and the rate of complete small bowel examination were compared. INTERVENTIONS On-demand polyethylene glycol and erythromycin were prescribed according to the progress as viewed by the real-time monitor. MAIN OUTCOME MEASUREMENTS Small bowel examination completion rate and gastric transit time. RESULTS Small bowel examination was completed in 19 (70.4%) and 17 (94.4%) patients undergoing conventional and real-time WCE, respectively (P = .048). With the real-time monitoring and on-demand preparations, gastric passage time was significantly reduced (100 vs 59 minutes, P = .02). LIMITATIONS Nonrandomized study. CONCLUSIONS The use of the real-time viewer may help to secure the passage of the capsule endoscope into the small bowel and hence result in a higher rate of complete small bowel examination.