The assessment of regional gut transit times in healthy controls and patients with gastroparesis using wireless motility technology

Abstract

Background: Wireless pH and pressure motility capsule (wireless motility capsule) technology provides a method to assess regional gastrointestinal transit times.

Aims: To analyse data from a multi-centre study of gastroparetic patients and healthy controls and to compare regional transit times measured by wireless motility capsule in healthy controls and gastroparetics (GP).

Methods: A total of 66 healthy controls and 34 patients with GP (15 diabetic and 19 idiopathic) swallowed wireless motility capsule together with standardized meal (255 kcal). Gastric emptying time (GET), small bowel transit time (SBTT), colon transit time (CTT) and whole gut transit time (WGTT) were calculated using the wireless motility capsule.

Results: Gastric emptying time, CTT and WGTT but not SBTT were significantly longer in GP than in controls. Eighteen percent of gastroparetic patients had delayed WGTT. Both diabetic and idiopathic aetiologies of gastroparetics had significantly slower WGTT (P < 0.0001) in addition to significantly slower GET than healthy controls. Diabetic gastroparetics additionally had significantly slower CTT than healthy controls (P = 0.0054).

Conclusions: In addition to assessing gastric emptying, regional transit times can be measured using wireless motility capsule. The prolongation of CTT in gastroparetic patients indicates that dysmotility beyond the stomach in GP is present, and it could be contributing to symptom presentation.

Figures

Figure 1

Wireless Motility Capsule Graph from a patient with gastroparesis. pH (magenta), Pressure (green), and Temperature (blue) profile showing Gastric Emptying signified by a >4 unit sharp pH rise at 5 hours, cecal arrival indicated by a 1 unit drop in pH at approximately 12 hours into the test and capsule body exit at 30 hours after the test started accompanied by a temperature drop.

Figure 2

Box and Whisker plots of healthy controls and gastroparesis patients. Gastric Emptying Time (2a), Colonic Transit Time (2c), and Whole Gut Transit Time (2d) are significantly prolonged in gastroparetics. Small Bowel Transit Time was not significantly different. Medians are shown as the lines within the box, the box boundaries are the 25th and 75th percentiles. Outliers are depicted by asterisks. The Y-axes are transit times in hours.