American Journal of Gastroenterology ISSN 0002-9270 C  2008 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2008.02090.x Published by Blackwell Publishing Effects of Ageing on Small Bowel Video-Capsule Endoscopy Examination Angelos A. Papadopoulos, M.D., Ph.D., 1 Konstantinos Triantafyllou, M.D., Ph.D., 1 Chryssostomos Kalantzis, M.D., Ph.D., 2 Adam Adamopoulos, M.D., Ph.D., 3 Dimitris Ladas, M.D., 1 Theodora Kalli, M.D., 1 Pericles Apostolopoulos, M.D., Ph.D., 2 Nikolaos Kalantzis, M.D., Ph.D., 2 and Spiros D. Ladas, M.D., Ph.D. 4 1 Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Medical School, Athens University, “Attikon” University General Hospital, Athens, Greece; 2 Gastroenterology Department, NIMTS Hospital, Athens, Greece; 3 3rd Department of Internal Medicine, Medical School, Athens University, “Sotiria” Hospital, Athens, Greece; and 4 1st Department of Internal Medicine-Propaedeutic, Medical School, Athens University, “Laiko” General Hospital, Athens, Greece OBJECTIVES: The effects of ageing on small bowel video-capsule endoscopy (VCE) studies have not been studied prospectively yet. METHODS: We prospectively investigated 120 consecutive VCE studies. Patients were divided into three age groups: <40, 40–64, and ≥65 yr. Two independent investigators examined the completion of the examination and measured the VCE gastric transit time (GTT), small bowel transit time (SBTT), and the proportion of VCE SBTT without clean intestinal mucosa. They also recorded study findings. RESULTS: We examined the videos of 32 (26.7%), 36 (30%), and 52 (43.3%) patients aged under 40, 40–64, and over 64 yr, respectively. VCE completion (cecum visualized) rate was similar in the three groups (81.2%, 77.8%, and 78.8%, respectively, P = 0.96). There was no difference in GTT (P = 0.22) and in SBTT (P = 0.8) among the three age groups. Although in univariate analysis, there was a trend (P = 0.057) for higher proportion of SBTT without clean mucosa in patients over 64 yr (22.65 [12.42–32.22]%) versus patients under 40 (12.65 [4.57–30.7]%) and patients aged 40–64 yr (12.55 [6.12–31.32]%), multivariate linear regression analysis has not confirmed this difference. Older patients had significantly less erosions and normal studies, but they had more angiodysplasias (P < 0.05). All four tumors were detected in the elderly. CONCLUSIONS: Ageing does not affect the completion rate and the quality of bowel preparation for VCE. However, elderly patients have fewer normal studies and more angiodysplasias and tumors in the small bowel. (Am J Gastroenterol 2008;103:1–7) INTRODUCTION Video-capsule endoscopy (VCE) is a well-accepted tool for the evaluation of small bowel mucosa lesions (1, 2). How- ever, incomplete examination of the small intestine by VCE occurs in about 20% of the patients (1, 3) This could be due to longer retention of the capsule in the stomach (4), because of food residue in the intestinal lumen, or green vis- cous fluid in the ileum prohibiting mucosal view (5), ow- ing to unsuspected strictures, technical failure of the cap- sule (2, 6), or patient’s underlying disorders such as diabetes mellitus (7). In some cases, no clear reason can be iden- tified (6). Efforts to increase study completion rate using bowel purge have failed. We have shown that different small bowel preparations have no significant effect on gastric and small-bowel VCE transit time, on the rate of cecum visual- ization, and on the quality of bowel preparation (3). The ef- fects of ageing on these factors have never been prospectively studied. The primary end points of the present study were to ex- amine the effect of ageing on VCE completion rate (cecum visualization) and on the quality of small bowel preparation. The secondary end point was to examine whether small bowel VCE findings in the aged are different as compared with the younger patients. PATIENTS AND METHODS This prospective, nonrandomized study on consecutive pa- tients was conducted in two tertiary hospitals in Athens, Greece, from October 2006 to July 2007. The study is part of an ongoing VCE project approved by the Ethics Committees of both hospitals and each participant gave informed consent. 1