A comprehensive examination of small-bowel capsule endoscopy in Spanish centers to meet European Society of Gastrointestinal Endoscopy standards.

Background and study aims In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) created a working group to develop technical and quality standards for small-bowel capsule endoscopy (SBCE) to improve the daily practice of endoscopy services. They developed 10 quality parameters, which have yet to be tested in a real-life setting. Our study aimed to evaluate the accomplishment of the quality standards in SBCE established by the ESGE in several Spanish centers. Materials and methods An online survey of 11 multiple-choice questions related to the ESGE performance measures was sent to Spanish centers with experience in SBCE. In order to participate and obtain reliable data, at least 100 questionnaires had to be answered per center because that is the minimum number established by ESGE. Results 20 centers participated in the study, compiling 2049 SBCEs for the analysis. Only one of 10 performance measures (cecal visualization) reached the minimum standard established by the ESGE. In five of 10 performance measures (Indication, lesion detection rate, terminology, and retention rate) the minimum standard was nearly achieved. Conclusions Our study is the first multicenter study regarding SBCE quality performance measures in a real setting. Our results show that the minimum standard is hardly reached in most procedures, which calls into question their clinical applicability in real life. We suggest performing similar studies in other countries to evaluate whether there is a need for quality improvement programs or a need to reevaluate the minimum and target values published so far.

Small Bowel Enteroscopy - A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups.

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.

Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Portugués de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores.

Small bowel enteroscopy - A joint clinical guideline by the Spanish and Portuguese small-bowel study groups.

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.

Prevalence of constipation: agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain.

The aims of this study were to estimate the prevalence of chronic constipation and to evaluate the diagnostic accuracy of the symptoms and the self-reported definition of constipation. A cross-sectional survey was conducted in the general community in 1999. A questionnaire comprising 21 items was developed and mailed to a random sample of 489 subjects who were aged between 18 and 65 years and who belonged to a Spanish population. In the 349 subjects (71%) responding to the questionnaire, the prevalence of self-reported constipation was 29.5% (95% confidence interval (CI): 24.9, 34.3) versus 19.2% (95% CI: 15.1, 23.3) and 14.0% (95% CI: 10.4, 17.7) based on Rome I and Rome II criteria, respectively. Agreement was good between self-reported and Rome I criteria (kappa: 0.68) and between Rome I and Rome II criteria (kappa: 0.71), and it was moderate between self-reported and Rome II criteria (kappa: 0.55). Female gender was identified to be a risk factor for constipation; fiber intake and physical exercise were found to be protective factors. Likelihood ratios were higher for the presence of anal blockage and straining and for the absence of hard stools. Chronic constipation is a highly prevalent problem, especially in women. Different prevalence estimates of constipation were observed using different criteria, although agreement between them was acceptable. Anal blockage, straining, and hard stools show the greatest accuracy for the diagnosis of constipation.