Z-line examination by the PillCam SB: prospective comparison of three ingestion protocols

World J Gastroenterol. 2010 Jan 7;16(1):63-8. doi: 10.3748/wjg.v16.i1.63.


Aim: To evaluate the Z-line visualization by the PillCam SB2 using three different ingestion protocols.

Methods: Ninety consecutive patients undergoing small bowel capsule endoscopy (SBCE) between January and May 2008 were included in the study. They swallowed the capsule in the standing (Group A = 30), supine (Group B = 30) and right supine positions (Group C = 30). Baseline patient characteristics, difficulties in capsule ingestion, esophageal transit times (ETT) and Z-line visualization were noted.

Results: No significant differences were found between the groups with regard to baseline patient characteristics, ingestion difficulties and complete SB examinations (P > 0.05). At least 1 frame of the Z-line was detected in 15.8%, 46.7% and 90% of patients in groups A, B and C, respectively (P < 0.001). The average number of Z-line images was 0.21 +/- 0.53, 3.23 +/- 6.59 and 5.53 +/- 7.55 and the mean % of the Z-line detected was 71.3, 25.1 and 8.3, in groups A, B and C, respectively (both P < 0.001). ETT times were longer in the supine group followed by the right supine and the standing groups (median of 237 s vs 64 s and 39 s, respectively; P < 0.001).

Conclusion: Z-line visualization in patients undergoing SBCE can be accurately achieved in most cases when the capsule is swallowed in the right supine position.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Capsule Endoscopes*
  • Capsule Endoscopy / methods*
  • Esophagoscopy / methods*
  • Esophagus / pathology*
  • Female
  • Gastrointestinal Transit
  • Humans
  • Intestine, Small / pathology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Supine Position