Clinical trial NCT01630109: Study of Metoclopramide in Small Bowel Capsule Endoscopy
Official title: Metoclopramide As An Adjunct To Small Bowel Capsule Endoscopy: Rate of Complete Evaluation And Affect on Transit Times
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Pill Capsule Endoscopy Completion Rates
Lead sponsor: Ascension Health
Sponsor class: INDUSTRY
First posted: 2012-06-28
Enrollment: 5
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: Patients undergoing small bowel capsule endoscopy will be randomized into 3 study groups to either receive 5 mg of metoclopramide, 10 mg of metoclopramide, or a placebo 30 minutes prior to swallowing the Pill Cam. This is a randomized, double-blind, placebo-controlled design. The outcomes to be assessed are capsule study completion rates, gastric transit time, small bowel transit time, and the effect of diabetes on pill capsule completion rates. The purpose of the study is to assess if metoclopramide given prior to pill capsule endoscopy has any effect on pill capsule completion rate, gastric transit time, small bowel transit time, and pill capsule completion rates in diabetes.

Detailed description: Pill Capsule Endoscopy allows Gastroenterologists to visualize the mucosa of the small bowel beyond the reach of any endoscope and to an extent never before possible. It involves the ingestion of a small pill camera approximately the size of a large vitamin. 8 hours of images are transmitted to a sensor worn around the patient's waist. At the conclusion of the test, these images are downloaded to a computer for physician review. Meanwhile, the PillCam™ passes naturally through the digestive system and does not require retrieval.

Many of these pill capsule studies are incomplete due to failure of the pill capsule to reach the colon. Metoclopramide (brand name Reglan) is an anti-emetic that also has known pro-motility effects in the GI tract. The thought behind this study is that metoclopramide will increase the rate of passage of the pill capsule through the GI tract allowing a higher completion rate of the pill capsule studies.

Patients scheduled for pill capsule endoscopy will be approached on the morning of their procedure to inform them of the research study. After proper consent is obtained the patient will receive either 5 mg Metoclopramide, 10 mg Metoclopramide, or a placebo pill 30 minutes prior to their pill capsule study. The pill capsule camera records 8 hours worth of data. The patient will return at the conclusion of their study to turn in their recorder. The ordering gastroenterologist will then read the study. Information regarding pill capsule completion (pill capsule goes through the ileocecal valve), gastric transit time, and small bowel transit time will then be recorded and analyzed.

Eligibility criteria: Inclusion Criteria:

* Men and women over the age of 18 undergoing pill capsule endoscopy to investigate unexplained rectal bleeding, anemia, iron deficiency, abdominal pain, altered bowel habits, and/or weight loss.

Exclusion Criteria:

* Inability to sign consent for research participation
* Inability to swallow PillCam™, placebo, or metoclopramide capsule
* Known hypersensitivity/allergy to metoclopramide
* Active congestive heart failure or respiratory failure requiring ventilator assistance
* Presence of cardiac pacemaker or implanted electromedical device
* Known bowel obstruction/stricture/fistula or intrauterine pregnancy
* Known history of Whipple procedure (pancreaticoduodenectomy), Billroth II surgery (partial gastrectomy with gastrojejunostomy), or gastric bypass surgery due to risk of capsule retention in a blind intestinal limb necessitating surgical retrieval
* Known history of seizure disorder, renal failure requiring dialysis, or pheochromocytoma
* Lactating women

Primary outcomes:
measure: Difference in Treatment vs. Placebo in Pill Capsule Completion Rates
timeFrame: 12 hours
Secondary outcomes:
measure: Differences in Gastric Transit Time in Treatment vs. Placebo in Pill Capsule Studies
timeFrame: 12 hours
measure: Differences in Small Bowel Transit Time in Treatment vs. Placebo in Pill Capsule Studies
timeFrame: 12 hours
measure: Difference in Pill Capsule Completion Rates in Diabetics vs. Non-diabetics
timeFrame: 12 hours
Other outcomes:
Locations:
city: Grand Blanc
country: United States
facility: Genesys Regional Medical Center
state: Michigan
Study officials:
affiliation: Ascension Health
name: Steven D Brooks, D.O.
role: PRINCIPAL_INVESTIGATOR
References: