TY - JOUR
T1 - Endoscopic removal of the wireless pH monitoring capsule in patients with severe discomfort
AU - Prakash, Chandra
AU - Jonnalagadda, Sreenivasa
AU - Azar, Riad
AU - Clouse, Ray E.
N1 - Funding Information:
Dr Prakash receives research support from Medtronic and Novartis, and additional support from Astra Zeneca. Dr Jonnalagadda receives support from Astra Zeneca; Dr Azar receives support from Wyeth Ayerst and Boston Scientific. Dr Clouse receives research support from the Sydney R. Baer, Jr. Foundation, Novartis, Medtronic, and Dr Clouse receives research support from the National Institutes of Health (DK63202).
PY - 2006/11
Y1 - 2006/11
N2 - Background: Few patients have significant symptoms during wireless esophageal pH monitoring, and the capsule typically sloughs spontaneously. Severe discomfort during monitoring can occur that requires endoscopic dislodgement of the capsule. Objective: To determine the frequency with which endoscopic capsule dislodgement is required and the outcomes of the intervention. Design: Chart review. Setting: University-based outpatient endoscopy facility. Patients: A total of 452 consecutive patients undergoing wireless pH monitoring over a 3.5-year period. Interventions: Endoscopic dislodgement of the capsule by using nudging with the endoscope tip and cold snare techniques. Results: Eight subjects (1.8%) required endoscopic capsule dislodgement because of severe chest pain or odynophagia (n = 7) or severe foreign-body sensation (n = 1). Chest pain was the initial indication for pH monitoring in 5 (62.5%) of the subjects. Initial nudging with the endoscope tip successfully dislodged 2 capsules; continued nudging produced mucosal stripping in 3 subjects, which required hemostasis in 1. A cold snare was used successfully, without complication, to separate the capsule from stripped mucosa and as a primary removal method in the remainder of subjects. Capsule removal uniformly resulted in marked improvement of discomfort. Conclusions: Endoscopic removal of the capsule was required in <2% of subjects who underwent wireless pH monitoring. Separation of the capsule from the mucosa with a cold snare may be the preferred method of accomplishing uncomplicated removal.
AB - Background: Few patients have significant symptoms during wireless esophageal pH monitoring, and the capsule typically sloughs spontaneously. Severe discomfort during monitoring can occur that requires endoscopic dislodgement of the capsule. Objective: To determine the frequency with which endoscopic capsule dislodgement is required and the outcomes of the intervention. Design: Chart review. Setting: University-based outpatient endoscopy facility. Patients: A total of 452 consecutive patients undergoing wireless pH monitoring over a 3.5-year period. Interventions: Endoscopic dislodgement of the capsule by using nudging with the endoscope tip and cold snare techniques. Results: Eight subjects (1.8%) required endoscopic capsule dislodgement because of severe chest pain or odynophagia (n = 7) or severe foreign-body sensation (n = 1). Chest pain was the initial indication for pH monitoring in 5 (62.5%) of the subjects. Initial nudging with the endoscope tip successfully dislodged 2 capsules; continued nudging produced mucosal stripping in 3 subjects, which required hemostasis in 1. A cold snare was used successfully, without complication, to separate the capsule from stripped mucosa and as a primary removal method in the remainder of subjects. Capsule removal uniformly resulted in marked improvement of discomfort. Conclusions: Endoscopic removal of the capsule was required in <2% of subjects who underwent wireless pH monitoring. Separation of the capsule from the mucosa with a cold snare may be the preferred method of accomplishing uncomplicated removal.
UR - http://www.scopus.com/inward/record.url?scp=33749998678&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2006.06.006
DO - 10.1016/j.gie.2006.06.006
M3 - Article
C2 - 17055889
AN - SCOPUS:33749998678
SN - 0016-5107
VL - 64
SP - 828
EP - 832
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 5
ER -