The Influence of Obesity on Small Bowel Capsule Endoscopy

Abstract

Objective. Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a $\text{body}\text{mass}\text{index}\left(\text{BMI}\right)\ge 25\text{kg}/{\text{m}}^2$ ). Results. The obese group was 54 patients (nonobese, $n=286$ ). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients ( $p=0.0026$ ), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients’ age (≥60 years) and in the patients’ hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, $p<0.0001$ ). An analysis using the outpatient/inpatient conditions showed that obesity was an independent factor in the inpatient status at the SBCE examination with a significant short SBTT (OR 2.91, 95% CI: 1.06–7.97, $p=0.0380$ ). Constipation at the examination was also a factor contributing to a long SBTT (OR 0.26, 95% CI: 0.07–0.99, $p=0.0493$ ). Conclusion. The SBTT of the SBCE was significantly shorter in the obese patients. This tendency was especially evident in the hospitalized state.