Rationale: Ingestible capsules enable visualization or direct measurement of conditions in the gastrointestinal (GI) tract with no need to sedate or anesthetize the patient, no radiation exposure, and with 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 obviate the need for more invasive tests and may improve patient tolerability and safety.

Technology Description: Wireless capsule systems, such as motility capsules and capsule endoscopes, are small, self-contained electronic devices in the shape of capsules that generate light and capture images or that measure temperature, pressure, and acid levels. The images and information collected can be stored in the capsule for later retrieval and analysis or wirelessly broadcast to a computer system that stores the images or information.

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

  • What is the diagnostic accuracy of wireless capsule systems for the detection of gastroparesis and GI motility disorders?
  • How does the diagnostic accuracy of these systems compare with other available methods of GI assessment?
  • What is the clinical utility of wireless capsule systems and does their use improve the outcomes of patients with gastroparesis or GI motility disorders?
  • Are wireless capsule systems safe for use in patients with GI motility disorders?
  • Have patient selection criteria been established for assessment of GI motility disorders with wireless capsule systems?

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