MCE Direct Visualization of Drug Behavior in Upper-gastrointestinal Tract

Overview

The investigators aim to explore the feasibility of MCE in direct, real-time visualization of drug behavior in upper-gastrointestinal tract, which presented by the adhesion, distribution, and dissipation characteristics of dyed sucralfate gel.

Full Title of Study: “Feasibility of Using Magnetically-controlled Capsule Endoscopy for Direct Visualization of Drug Behavior in Upper-gastrointestinal Tract”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: October 22, 2019

Detailed Description

This pilot study was a prospective, single-centered, nonrandomized study. The investigators selected 10 subjects from patients with a recent history of upper-gastrointestinal symptoms who met the indication of taking sucralfate suspension gel, and another 10 subjects from healthy volunteers. Procedures were performed by the NaviCam magnetic capsule guidance system. To enhance discrimination, the sucralfate gel dyed with 0.3 ml methylene blue. The subjects swallowed the capsule with water in the left lateral position. When capsule enter stomach cavity, subject was asked to sit up and ingested 4 g aerogenic powder with 5 ml water to distend the stomach, and performed gastric baseline examinations to identify the lesions. After baseline examination, subjects ingested dyed sucralfate gel and performed the first-time examination. The examination was repeated at 30 min intervals, until dyed sucralfate gel disappeared completely. When study completed, the capsule was detached from string and continued into the small bowel for further examination. The endoscopists recorded the adhesion and dissipation times of dyed sucralfate gel, calculated the efficient time, and selected the images of six primary anatomic landmarks from each examination to measure the distribution area (%) . Any complication or discomfort during the procedure was evaluated. The discomfort was scored on a scale from 0 to 3 (0 = no; 1 = mild/minimal; 2 = moderate; 3 = sever/very difficult).

Interventions

  • Device: Magnetically controlled capsule endoscopy
    • The subjects swallowed the capsule with water in the left lateral position. When capsule enter stomach cavity, subject was asked to sit up and ingested 4 g aerogenic powder with 5 ml water to distend the stomach, and performed gastric baseline examinations to identify the lesions. After baseline examination, subjects ingested dyed sucralfate gel and performed the first-time examination. The examination was repeated at 30 min intervals, until dyed sucralfate gel disappeared completely.

Arms, Groups and Cohorts

  • Abdominal symptoms group
    • The investigators selected 10 subjects (male: female = 1: 1) from patients with a recent history of upper-gastrointestinal symptoms who met the indication of taking sucralfate suspension gel
  • Healthy control group
    • The investigators selected another 10 subjects (male: female = 1: 1) from healthy volunteers.

Clinical Trial Outcome Measures

Primary Measures

  • Sucralfate gel adhesion behavior in the fasted gastric cavity
    • Time Frame: 180 minutes
    • The adhesion time was recorded from the sucralfate gel entered the stomach to all sucralfate adhered to the gastric wall.
  • Sucralfate gel distribution behavior in the fasted gastric cavity
    • Time Frame: 0, 30, 60, 90, 150, 180 min after dyed sucralfate gel enter the stomach
    • The distribution area of sucralfate gel was measured by selecting images of six primary anatomic landmarks (cardia, fundus, body, angulus, antrum, and pylorus) at different times, the images were imported into MATLAB software to calculate the area of sucrafate gel. The dynamic changes of distribution area of sucralfate gel over the time were analyzed and performed with GraphPad Prism.
  • Sucralfate gel dissipation behavior in the fasted gastric cavity
    • Time Frame: 180 minutes
    • The dissipation time was evaluated by calculating the times between sucralfate gel entered the stomach and adhered sucralfate disappeared completely.

Secondary Measures

  • Number of Participants with complications of MCE
    • Time Frame: 2 weeks
    • Any complications associated with MCE.
  • Discomfort scores of participants during the procedure
    • Time Frame: during the procedure
    • The discomfort associated with the procedure included swallow difficulty, nausea caused by string, pulling capsule up and down, abdominal distension or pain caused by ingesting aerogenic powder, discomfort during MCE examination, and pulling the string out. The discomfort was scored on a scale from 0 to 3 (0 = no; 1 = mild/minimal; 2 = moderate; 3 = sever/very difficult).

Participating in This Clinical Trial

Inclusion Criteria

  • With or without gastrointestinal complaints – Scheduled to undergo a capsule endoscopy for both stomach and small bowel – Signed the informed consents before joining this study Exclusion Criteria:

  • Suspected or known gastrointestinal stenosis – Obstruction or other known risk factors for capsule retention – Pregnancy or suspected pregnancy – Pacemakers or electromedical devices implanted – Any other contraindications determined by endoscopists

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Changhai Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Zhuan Liao, M.D., Associate Professor, Associate Chief Physician – Changhai Hospital
  • Overall Official(s)
    • Zhuan Liao, Study Chair, Changhai Hospital

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