P226 Does Prucalopride improve outcomes in colon capsule endoscopy?

• Published in: Gut Vol. 72; no. Suppl 2; p. A170
• Main Authors: Pillay, Lushen, Esan, Oluwatobi, Ana-Georgiana Petre, Macedo, Mario, McStay, Mary
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Colon; Constipation; Demography; Endoscopy; Gastric motility; Motility; Pathology; Patients; Polyps; Risk factors
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2023-BSG.294

IntroductionColon capsule endoscopy (CCE) is a non-invasive way in which to visualize the colon. At present there is a national NHS pilot study evaluating the use of CCE for symptomatic patients referred on a lower GI cancer pathway with a faecal immunochemical test result of 10–100 ug/gm. Prucalopride is used in the treatment of chronic constipation; it is a selective agonist of the 5HT-4 receptor, has a prokinetic effect, and improves gastrointestinal motility. A recent large Danish study showed higher completion rate and polyp detection rates (PDR) in patients who received prucalopride prior to ingestion of the CCE,1 which lead to the NHS CCE pilot programme recommending its usage. It is recommended that patients who have risk factors for slow GI motility are given 2mg of prucalopride, while all others are given 1mg prior to swallowing the capsule. The aim of our audit to evaluate the difference in outcomes of CCE between patients who received prucalopride to date and those who did not.MethodsThis was a retrospective observational audit. We compared the demographics, capsule transit times, completion rates and PDR between all patients who had received prucalopride in our department and an equal number of unmatched patients whom did not receive prucalopride. The majority of patients were enrolled on the NHS pilot. Data was collected by reviewing procedure reports.ResultsA total of 49 patients in each cohort were included.Abstract P226 Table 1Summary of results:Table 1A: Demographics in each cohort Demographic Pre-prucalopride cohort Post-prucalopride cohort Gender Female: 20 Male: 29 Female: 26 Male: 23 Mean Age: 65.7 60.1 Table 1B: Results comparing various outputs in both cohorts. Pre-prucalopride Post-prucalopride P-value Colonic transit time 315 minutes 263 minutes 0.139 Polyp detection rate 51% 59% 0.417 CCE Completion rate 77% 84% 0.443 Colonic transit time <40minutes* 4 8 (4 who received 1mg, 4 who received 2mg) - *Transit time <40minutes thought to increase risk of missing pathology during reading.ConclusionIn our audit, patients who received prucalopride for CCE had reduced colonic transit times, increased completion rates and increased polyp detection rates compared to those who received standard bowel preparation. This difference did not reach statistical significance (likely due to small numbers in each group). A higher number of patients who received prucalopride group had a colon transit time of <40 min, and consideration should be made as to whether this might increase the risk of missing significant pathology.ReferenceDeding U, et al. Clinical Epideminology 2022;14:437–444.