Are symptomatic changes in irritable bowel syndrome correlated with the capsule endoscopy transit time? A pilot study using the 5-HT4 receptor agonist mosapride.

BACKGROUNDS/AIMS: A prospective correlation study of symptomatic changes due to administration of prokinetic drugs and changes of transit time of capsule endoscopy (CE), for patients with constipation-predominant irritable bowel syndrome (IBS-C), and examination of usefulness of CE in the objective evaluation of IBS-C.

METHODOLOGY: Mosapride citrate was administered to ten subjects and CE transit evaluated together with a symptom questionnaire before and after administration. Frequency and severity of abdominal pain, times of defecation and Bristol stool scales were listed and scored. Primary and secondary endpoints were the correlation between symptomatic changes due to the administration and changes of CE transit and the effect of mosapride citrate on IBS-C, CE findings, and gastric and small bowel transit time (GTT, SBTT).

RESULTS

After administration for 4 weeks, the mean scores of evaluated symptoms all improved. GTT was not significantly changed, but SBTT showed significant shortening post-administration (p=0.02). In only one patient's CE, three small erosions were detected. The changes in the times of defecation before and after the administration were significantly correlated with those in the SBTT of CE (R=0.888, p=0.0006). However, other symptoms were not significantly correlated with SBTT.

CONCLUSIONS

CE transit correlated with intestinal motility in symptomatic changes and could be a possible index for the objective assessment of motility in IBS-C.