Role of wireless motility capsule in diagnosing diabetic gut autonomic neuropathy: A narrative review

Abstract

Gastroparesis is known as delayed gastric emptying in the absence of mechanical obstruction, typical symptoms being nausea, vomiting, bloating, early satiety, and upper abdominal pain. Gastroparesis is much prevalent in type 2 diabetes mellitus patients. Currently, methods used for the assessment of gastrointestinal (GI) motility involve radiation and invasiveness and are mostly limited to regional assessment, with a lengthy hospital stay, and most of the tests are even not standardized. Gastric emptying scintigraphy (GES) using a radiolabeled meal is the gold standard diagnostic test used to detect and quantify gastroparesis. The advantages of this test are physiological, economical, and non-invasive characteristics. However, lack of standardization poses radiation exposure. As diabetic patients already suffer from diabetic complications and comorbidities, availability of diagnostic tests by offering a non-radioactive, standardized, and ambulatory investigation may be a better alternative to GES to prevent unnecessary radiation exposure. This review summarizes the role of wireless motility capsule (WMC) in diagnosing gut diabetic autonomic neuropathy. The WMC is a novel technology that allows the physician to measure GI motility in a convenient, ambulatory, relatively non-invasive way, without exposing the patient to radiation. The WMC also established its diagnostic utility to assess diabetic gastroparesis in many multicentric studies; although it has some contraindications and limitations, it is the best available novel technology for diagnosing gut diabetic autonomic neuropathy.

Keywords

• diabetes mellitus
• diabetic autonomic neuropathy
• gastrointestinal motility
• gastroparesis
• smartpill
• wireless motility capsule