Digestive Diseases and Sciences

, Volume 54, Issue 10, pp 2167–2174 | Cite as

Wireless Capsule Motility: Comparison of the SmartPill® GI Monitoring System with Scintigraphy for Measuring Whole Gut Transit

  • Sabba Maqbool
  • Henry P. Parkman
  • Frank K. Friedenberg
Original Article



Assessment of whole gut transit, by radio-opaque markers or scintigraphy, is used to evaluate patients with constipation for slow gastrointestinal transit. Wireless capsule motility, using the SmartPill® GI monitoring system, samples and transmits intraluminal pH, pressure, and temperature data from a capsule at regular intervals as it traverses through the gastrointestinal tract; from these, gastric emptying and whole gastrointestinal tract transit can be assessed. The objective of this study was to compare the SmartPill® with whole gut transit scintigraphy to determine whether the SmartPill system could serve as a test for measurement of whole gut motility and transit.


Ten healthy, asymptomatic subjects underwent simultaneous whole gut scintigraphy and SmartPill® assessment of whole gut transit.


All subjects completed the study per protocol and experienced natural passage of the pill. Capsule residence time in the stomach correlated very strongly with percent gastric retention of the Tc-99 radiolabel at 120 min (r = 0.95) and at 240 min (r = 0.73). Small bowel contraction-min−1 measured by the SmartPill correlated with small bowel transit % (r = 0.69; P = 0.05) and with isotopic colonic geometric center at 24 h after ingestion (r = 0.70, P = 0.024). Capsule transit time correlated with scintigraphic assessment of whole gut transit.


SmartPill® capsule assessment of gastric emptying and whole gut transit compares favorably with that of scintigraphy. Wireless capsule motility shows promise as a useful diagnostic test to evaluate patients for GI transit disorders and to study the effect of prokinetic agents on GI transit.


Wireless capsule motility GI transit Gastric emptying Colonic transit 



Total capsule transit time


Total time for isotope excretion




Whole gut transit scintigraphy



Financial Support: Supported by an investigator-initiated grant from ViroPharma, Inc., Exton, PA to F.K.F.


  1. 1.
    Cremoni F, Mullan BP, Camilleri M, Burton DD, Rank MR. Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther. 2002;16:1781–1790.CrossRefGoogle Scholar
  2. 2.
    Maurer AH, Krevsky B. Whole-gut transit scintigraphy in the evaluation of small bowel and colon transit disorders. Semin Nucl Med. 1995;25:326–338.PubMedCrossRefGoogle Scholar
  3. 3.
    Bonapace ES, Maurer AH, Davidoff S, Krevsky B, Fisher RS, Parkman HP. Whole gut transit scintigraphy in the clinical evaluation of patients with upper and lower gastrointestinal symptoms. Am J Gastroenterol. 2000;95:2838–2847.PubMedCrossRefGoogle Scholar
  4. 4.
    Kuo B, McCallum RW, Koch KL, et al. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Aliment Pharmacol Ther. 2008;27:186–196.PubMedCrossRefGoogle Scholar
  5. 5.
    Gaman A, Kuo B. A non-digestible device discriminates motility patterns with a luminal acidic pH change within the distal small bowel and proximal colon. Gastroenterology. 2007;132:A-458.Google Scholar
  6. 6.
    Cassilly D, Kantor S, Knight LC, et al. Gastric emptying of a non-digestible solid: assessment with simultaneous SmartPill pH and pressure capsule, antroduodenal manometry, gastric emptying scintigraphy. Neurogastroenterol Motil. 2008;20(4):311–319.PubMedCrossRefGoogle Scholar
  7. 7.
    Rao SS, Kuo B, McCallum RW, et al. Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation. Clin Gastroenterol Hepatol. 2009;7(5):537–544.PubMedCrossRefGoogle Scholar
  8. 8.
    Tougas G, Eaker EY, Abell TL, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000;95:1456–1462.PubMedCrossRefGoogle Scholar
  9. 9.
    Abell TL, Camilleri M, Donohoe K, et al. Consensus Recommendations for Gastric Emptying Scintigraphy: A Joint Report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54.PubMedCrossRefGoogle Scholar
  10. 10.
    Evans DR, Pye G, Bramley R, et al. Measurement of gastrointestinal pH profiles in normal ambulant human subjects. Gut. 1988;29:1035–1041.PubMedCrossRefGoogle Scholar
  11. 11.
    Fallingborg J, Christensen LA, Ingeman-Nielsen M, et al. pH-profile and regional transit times of the normal gut measured by a radiotelemetry device. Aliment Pharmacol Ther. 1989;3:605–613.PubMedGoogle Scholar
  12. 12.
    Camilleri M, Malagelada JR, Brown ML, Becker G, Zinmeister AR. Relation between antral motility and gastric emptying of solids and liquids in humans. Am J Physiol. 1985;249:G580–G585. (Gastrointest Liver Physiol 12).PubMedGoogle Scholar
  13. 13.
    Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32:920–924.PubMedCrossRefGoogle Scholar
  14. 14.
    Zarate N, Knowles CH, Newell M, et al. In patients with slow transit constipation, the pattern of colonic transit delay does not differentiate between those with and without impaired rectal evacuation. Am J Gastroenterol. 2008;103:427–434.PubMedCrossRefGoogle Scholar
  15. 15.
    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;i:307–310.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Sabba Maqbool
    • 1
  • Henry P. Parkman
    • 1
  • Frank K. Friedenberg
    • 1
  1. 1.Gastroenterology Section, Department of Medicine, 8th Floor Parkinson PavilionTemple University School of MedicinePhiladelphiaUSA

Personalised recommendations