Use of an Ambulatory Capsule to Characterize Gastrointestinal Pressure Patterns in Children

ADM is a standard procedures used in children, but it has some limitations and disadvantages. Manometry studies involve placing catheters in the nose and are often poorly tolerated by children. Also, placement of the catheter requires sedation or anesthesia, the manometry test lasts several hours and involves ingestion of a meal which many children find difficult when having a catheter in their nose. The reason we are conducting this study is because we would like to find a new, less invasive, equally informative test for understanding gastrointestinal motility.

The SmartPill GI Monitoring System uses a capsule, about the size of a large vitamin or PillCam capsule, which is swallowed and passed through the stool. While in the GI tract, the capsule measures the acidity (pH) and pressures, and these measurements are used to determine how long it takes for food to leave the stomach. Pressure and pH information are sent by the capsule to a receiver that the patient will either wear on the belt or keep within 2 feet. The receiver stores data collected about the pH, temperature, and pressure inside the GI tract. The SmartPill GI Monitoring System has already been approved by the Food and Drug Administration (FDA) for use in adults but not in children.

Inclusion criteria

• Children older than 10 years of age referred to our Motility Center to receive AD manometry studies will be offered participation to the study
• The patients will have to be able to swallow the SmartPill capsule
• The patients will need to have no evidence of strictures or narrowing

Exclusion criteria

• Inability to swallow the capsule
• Patients on TPN because of inability to tolerate enteral feedings (high likelihood of not emptying the capsule from the stomach)
• Children with evidence of strictures
• Children with history of esophageal or gastric surgeries, such as TE fistula, fundoplication, or gastrojejunostomy
• Children with a history of gastric bezoars
• Allergies to components of the test meal including eggs, bread, and jam
• Patients with history of inflammatory bowel disease