Study comparing oesophageal capsule endoscopy versus EGD in the detection of varices

BACKGROUND: Endoscopic screening and surveillance of cirrhotic patients for oesophageal varices is advocated before initiation of prophylactic therapy for prevention of the first variceal haemorrhage. AIMS: To compare the diagnostic yield of oesophageal capsule endoscopy (ECE) with Esophagogastroduodenoscopy (EGD) for detecting and grading oesophageal varices and to determine patient tolerance for each procedure. PATIENTS: Twenty consecutive cirrhotic patients scheduled for EGD were enrolled in the study. METHODS: Patients underwent ECE followed by EGD. Patients completed a visual analogue scale after each procedure, assessing level of anxiety, pain, overall satisfaction, and willingness to repeat each procedure. RESULTS: On EGD, 19/20 patients had oesophageal varices. ECE detected varices in 13/19 (68% sensitivity). ECE identified nine out of ten varices rated grade II or higher on EGD. The post-study analogue scale showed a greater level of anxiety before EGD (avg. 2.75/10) versus ECE (avg. 1.5/10). CONCLUSIONS: ECE may be used in the assessment of EV. It appears to have more discordance with EGD when evaluating smaller varices. The minimal discomfort, lack of sedation, and decreased risk make ECE a possible substitute to EGD in patients unable or unwilling to undergo EGD.