Focus of the Report: The focus of this Health Technology Assessment is evaluation of the effectiveness and safety of wireless capsule endoscopy (WCE) compared with established techniques for diagnosis and guidance of the management of small and large bowel motility disorders.
Technology Description: Wireless capsule systems directly measure conditions in the gastrointestinal (GI) tract with no need to sedate or anesthetize the patient, no radiation exposure, and little supervision or effort needed by the nurse or physician who monitors the procedure. Testing with wireless capsule systems offers an alternative to standard tests of GI motility, most of which are invasive and some of which involve exposure to x-rays or radioactive materials. These devices can potentially gather enough data regarding motility to enable avoidance of more invasive tests and may improve patient tolerability and safety.The patient ingests the capsule and wears or keeps a data receiver nearby to collect the information transmitted by the capsule.
Controversy: Although wireless capsule systems are minimally invasive, there is a risk that the capsule will become lodged in the small bowel and require another procedure to dislodge or remove it. Furthermore, wireless capsule endoscopy may not provide any more diagnostic information than noninvasive or minimally invasive conventional methods for assessment of GI motility.
Key Questions:
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Is WCE effective for diagnosis and guidance of the management of small and large bowel motility disorders?
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How does WCE compare with established methods for diagnosis and guidance of the management of small and large bowel motility disorders?
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Is WCE safe in patients who have suspected small and large bowel motility disorders?
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Have definitive patient selection criteria been identified for WCE for diagnosis and guidance of the management of small and large bowel motility disorders?