New objective evaluation method for functional bowel disorder using video capsule endoscopy.

AIM: The aim of the present study was to use video capsule endoscopy (VCE) to objectively evaluate bowel movements in patients with irritable bowel syndrome (IBS) compared with healthy volunteers. METHODS: Subjects were nine healthy volunteers (group A) and five IBS patients (group B) whose VCE reached the cecum within the examination time. As the darkest component in an image of VCE is the lumen, we regarded real movements of the intestine observed in the images as the changes of luminal movement, and analyzed them. We trimmed the luminal edge, counted pixels in the lumen and the low brightness area (LBA), of all VCE images and compared them between the groups. RESULTS: There was no difference in the frequency observed in the LBA corresponding to the luminal area between the groups. As for the average volume of the LBA found in an image, it was 1702 pixels in healthy persons versus 305 in IBS patients (P = 0.21) and in healthy persons it tends to be larger. We drew a graph of LBA by time-course. A periodic change in the volume of LBA was found in eight of nine (88.9%) healthy persons over time, but in only two of five (40.0%) IBS patients (P = 0.62). Using endoscopy, a difference in the bowel movement between groups A and B could be evaluated objectively. CONCLUSION: The present study presents the possibility of a new technique to evaluate functional bowel disorders objectively using an endoscopic procedure.