Population-Based Prevalence of Gastrointestinal Abnormalities at Colon Capsule Endoscopy

Fanny E.R. Vuik, Stella A.V. Nieuwenburg, Sarah Moen, Eline H. Schreuders, Marinka D. Oudkerk Pool, Elisabeth F.P. Peterse, Cristiano Spada, Owen Epstein, Ignacio Fernández-Urién, Albert Hofman, Ernst J. Kuipers, Manon C.W. Spaander*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Background & Aims: The population prevalence of gastrointestinal (GI) disease is unclear and difficult to assess in an asymptomatic population. The aim of this study was to determine prevalence of GI lesions in a largely asymptomatic population undergoing colon capsule endoscopy (CCE). Methods: Participants aged between 50-75 years were retrieved from the Rotterdam Study, a longitudinal epidemiological study, between 2017-2019. Participants received CCE with bowel preparation. Abnormalities defined as clinically relevant were Barrett segment >3cm, severe ulceration, polyp >10 mm or ≥3 polyps in small bowel (SB) or colon, and cancer. Results: Of 2800 invited subjects, 462 (16.5%) participants (mean age 66.8 years, female 53.5%) ingested the colon capsule. A total of 451 videos were analyzed, and in 94.7% the capsule reached the descending colon. At least 1 abnormal finding was seen in 448 (99.3%) participants. The prevalence of abnormalities per GI segment, and the most common type of abnormality, were as follows: Esophageal 14.8% (Barrett's esophagus <3 cm in 8.3%), gastric 27.9% (fundic gland polyps in 18.1%), SB abnormalities 33.9% (erosions in 23.8%), colon 93.3% (diverticula in 81.2%). A total of 54 participants (12%) had clinically relevant abnormalities, 3 (0.7%) in esophagus/stomach (reflux esophagitis grade D, Mallory Weiss lesion and severe gastritis), 5 (1.1%) in SB (polyps > 10 mm; n = 4, severe ulcer n = 1,) and 46 (10.2%) in colon (polyp > 10 mm or ≥3 polyps n = 46, colorectal cancer n = 1). Conclusions: GI lesions are very common in a mostly asymptomatic Western population, and clinically relevant lesions were found in 12% at CCE. These findings provide a frame of reference for the prevalence rates of GI lesions in the general population.

Original languageEnglish
Pages (from-to)692-700.e7
JournalClinical Gastroenterology and Hepatology
Volume20
Issue number3
Early online date29 Oct 2021
DOIs
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
The authors thank Sophia van Baalen-Van Daalen and the endoscopy nurses of Camerapil for their contribution reviewing the colon capsules videos. They also thank all employees of the Rotterdam Study working in health care center Ommoord for their help in the logistics of this study.

Funding Information:
Funding This study was supported by a grant from Health Holland, including Medtronic, Camerapil BV and the Dutch Cancer Society.

Publisher Copyright:
© 2022

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