Skip to main content
Download PDF

Positioning exercises in improving the quality of magnetic-controlled capsule endoscopy

BMC Gastroenterology volume 24, Article number: 313 (2024) Cite this article

Abstract

Background

Good gastric preparation is indispensable for Magnetic-controlled Capsule Endoscopy (MCE) examination, but there is no consensus yet. We aim to explore the clinical application value of positioning exercises in improving the quality of MCE examination.

Methods

Clinical data of 326 patients who underwent MCE examination from January 2020 to December 2023 were collected. The included patients were divided into two groups: the conventional medication preparation group (CMP group, accepted mucosal cleansing medication only) and the positioning exercises group (PE group, accepted mucosal cleansing medication plus positioning exercises). A comparison was made between the two groups in terms of gastric cavity cleanliness score, visibility score, and detection rate of positive lesions.

Results

The examination time was (21.29 ± 5.82) minutes in the PE group and (30.54 ± 6.37) minutes in the CMP group, showing a significant difference between the two groups (P < 0.001). The total cleanliness score and visibility score in the CMP group were 15.89 ± 2.82 and 10.93 ± 2.12, respectively. In contrast, the total cleanliness score and visibility score in the PE group were 19.52 ± 2.26 and 15.09 ± 2.31, respectively. The PE group showed significantly better cleanliness scores and visibility scores in all six anatomical regions compared to the CMP group (All P < 0.001). However, there was no significant difference in the detection rate of positive lesions between the two groups (All P > 0.05).

Conclusion

Positioning exercises before MCE examination can improve the quality of gastric mucosal images and reduce the duration of the examination for patients.

Peer Review reports

Background

The use of magnetically controlled capsule endoscopy (referred to as Magnetic-controlled Capsule Endoscopy or MCE, or Magnetic-Assisted Capsule Endoscopy or MACE) enables non-invasive examination of the entire stomach and has been widely applied in clinical practice. Research has shown that magnetic-controlled capsule endoscopy is a non-invasive, painless, comfortable, and safe diagnostic device for gastrointestinal diseases. It has become an important tool for initial screening and examination of digestive tract diseases [1,2,3,4]. Multiple studies have confirmed that magnetic-controlled capsule endoscopy demonstrates high consistency with traditional electronic gastroscopy in terms of identification and diagnostic accuracy of gastric diseases [5, 6].

Magnetic-controlled capsule endoscopy lacks the suction and flushing capabilities of traditional gastroscopy, which can lead to compromised visualization and potential missed diagnoses due to the presence of foam, mucus, bile, and food debris in the stomach [7]. Defoaming agents and mucolytic agents have been widely employed in the preparation for both traditional gastroscopy and magnetic-controlled capsule endoscopy examinations [8,9,10]. Patients achieved satisfactory results in terms of direct visualization of the gastric cavity after taking defoaming agents and mucolytic agents to eliminate turbid mucus and bubbles [11]. However, not all patients were able to obtain a clear view, which may be attributed to incomplete coverage of the gastric mucosa by the defoaming and mucolytic agents. Over time and clinical experience increase, gastric preparation becomes better, which helps to improve the efficiency of MCE. Although there are many methods of gastric preparation being explored, such as the use of different mucosal cleansing medication and position changes, there is still no consensus.Also, many potential factors that may influence the effect of gastric preparation. Therefore, we explored the use of positioning exercises to ensure optimal coverage of the gastric mucosa by the defoaming and mucolytic agents, aiming to improve the cleanliness and clarity of the visual field.

Methods

Population

Patients who underwent MCE examination at the Endoscopy Center of The First Affiliated Hospital of Xiamen University from January 2020 to December 2023 were included. Patients were randomly divided into two groups according to the method of random number table. The inclusion criteria were as follows: (1) individuals who were unwilling or unable to tolerate gastroscopy (including painless gastroscopy); (2) good cognitive and language communication abilities. The exclusion criteria were as follows: (1) younger than 18 years old or older than 75 years old; (2) known allergies to the medications used in this study, active upper gastrointestinal bleeding, malignant tumors, gastrointestinal obstruction/narrowing, or swallowing disorders; (3) individuals with mobility issues or inability to cooperate; (4) those without surgical conditions or who refused any abdominal surgery; (5)individuals with congestive heart failure, liver or kidney dysfunction, and so on.

The flow chart of the study is depicted in Fig. 1. After the inclusion and exclusion, patients were divided into two groups according to gastric preparation protocol received, the conventional medication preparation group (CMP group, accepted mucosal cleansing medication only) and the positioning exercises group (PE group, accepted mucosal cleansing medication plus positioning exercises).All patients who underwent MCE examination were required to obtain informed consent before the examination. This study was performed in accordance with medical ethics and was approved by the Human Research Ethics Committee of The First Affiliated Hospital of Xiamen University (Xiamen, China).

Fig. 1
figure 1

The flow chart of the study

Full size image

The MCE system

The equipment used for the examination was the MCE system from Ankon Technology Co. Ltd (Shanghai, China), including the control system, capsule endoscope, data recorder, computer workstation, and real-time display and control software installed on the computer workstation. For detailed specifications, please refer to previous studies [12,13,14]. The operator manipulated the joystick to adjust the magnetic field strength and control the movement of the capsule.

Gastric preparation regimen and MCE examination protocol

We arrange a full-time nurse to detailed the patient the MCE examination process and precautions, especially in gastric preparation, in order to better adherence to preparation protocols. After fully evaluated the patient’s condition, they were advised to discontinue the oral medication before the gastric preparation to reduce the effect of the medication on the examination.

Both groups of patients were instructed to fast for at least 8 h before the examination and signed an informed consent form for capsule endoscopy.

The MCE examination protocols were as follow:

Frist, prior to the examination, a dedicated person prepared the medication required for capsule endoscopy. 20,000 U of chymotrypsin and 1 g of sodium bicarbonate were dissolved in 50 ml of drinking water (kept at approximately 30 °C using a thermos container). After thorough stirring and dissolution with a stirring rod, 10 ml of dimethyl silicone oil was added and mixed well. The patients were instructed to take this solution 40 min before the examination.

Second, in the 10 min before the examination, the patients were instructed to drink water gradually to induce a feeling of bloating in the abdomen (500–1000 ml), to achieve gastric distension.

The PE group implemented a positioning exercise program based on the preparation method of the CMP group. Patients of the CMP group accepted the above two steps, and underwent MCE examination immediately after drinking water. But patients of the PE group accepted positioning exercises program for about 5 min after drinking water, and then underwent MCE examination. One nurse was responsible for guiding the positioning exercises.

Last, upon entering the examination room, the patients removed any metallic items such as watches, keys, and jewelry, and wore the examination gown. The patients assumed a left lateral decubitus position, swallowed the capsule with a small amount of water, and the examination began. When the capsule endoscope entered the stomach, the operator manipulated the magnetic ball to guide the capsule in sequentially examining the fundus, cardia, body, angle, antrum, and pylorus of the stomach. Each region was examined twice, and the procedure was concluded. All patients were followed up for two weeks to confirm the passage of the capsule and record any adverse events [15].

Score 2 or score 1 in cleanliness and score 1 in visualization should accept further conventional gastroscopy. Conventional gastroscopy to obtain biopsy or for therapeutic intervention was performed according to standard practice if lesions were identified by MCE examination.

Positioning exercises

The steps of positioning exercises include: (1) hands hanging down, bending forward (≥ 90°) for six beats; (2) hands raised overhead, stretching backward for six beats; (3–4) hands on waist, lateral movement, six beats each left and right; (5) hands on waist, twisting the waist, six beats each left and right. Repeat the steps five times (Fig. 2).

Fig. 2
figure 2

The steps of positioning exercises include: (1) hands hanging down, bending forward (≥ 90°) for six beats; (2) hands raised overhead, stretching backward for six beats; (3–4) hands on waist, lateral movement, six beats each left and right; (5) hands on waist, twisting the waist, six beats each left and right. Repeat the steps five times

Full size image

In this study, all cases were performed by experienced endoscopists. According to the examination requirements, the operator demands the patient to change the position, prolong examination time or increase water intake for a good vision for both CMP group and PE group. Another endoscopist with 3 years of experience in image interpretation independently assessed the image quality of the magnetic-controlled capsule endoscopy images without knowledge of patient grouping information.

Study outcome and definition

The main outcome measure of this study is the video quality of magnetic-controlled capsule endoscopy. Secondary outcome measures include examination time, safety, and detection of positive lesions using magnetic-controlled capsule endoscopy. Positive lesions include chronic gastritis, polyps, ulcers, tumors, etc. The gastric examination time (GET) is defined as the time from the first gastric imaging to the completion of the gastric examination under magnetic control [16]. Adverse events are defined as abdominal distension, abdominal pain, vomiting, gastrointestinal obstruction, and capsule retention.

To evaluate the quality of MCE videos, scores of gastric cleanliness and mucosal visualization in six primary anatomical landmarks of the stomach (cardia, fundus, body, angulus, antrum, and pylorus) were recorded. A 4-point grading scale was introduced to define the cleanliness as excellent (no more than small bits of adherent mucus and foam: score 4), good (small amount of mucus and foam, but not enough to interfere with the examination: score 3), fair (considerable amount of mucus or foam present precluding a completely reliable examination: score 2) and poor (large amount of mucus or foam residue: score 1) [13, 17]. As for mucosal visualization, a 3-point grading scale was introduced as good (> 90% of the mucosa observed: score 3), fair (70–90% of the mucosa observed: score 2) and poor (< 70% of the mucosa observed: score 1) as used in our previous study. Scores for total gastric cleanliness and total mucosal visualization were obtained by summating the individual scores of the six anatomical landmarks [13].

Statistical analysis

The data analysis was performed using SPSS 25.00 statistical software. Categorical data were described using frequencies and percentages, and the comparison between groups was conducted using the chi-square test. Normally distributed continuous data were described using means and standard deviations, and group comparisons were made using the Student’s t-test. Group comparisons were analyzed using non-parametric statistical tests. Semi-quantitative ordinal data, such as quality scores of magnetic-controlled capsule endoscopy (cleanliness and visibility), were compared using the Kruskal-Wallis test. A two-tailed P value less than 0.05 was considered statistically significant.

Results

Patients

From January 2020 to December 2023, a total of 326 patients underwent MCE examination. However, 16 cases were excluded due to age criteria (10 patients exceeding 75 years old, 6 patients below 18 years old), and 3 cases withdrew from the examination due to gastric retention. Therefore, a total of 307 cases were included in the final analysis, with 159 cases in the CMP group and 148 cases in the PE group. (Fig. 1) The examination time was (21.29 ± 5.82) minutes in the PE group and (30.54 ± 6.37) minutes in the CMP group, showing a significant difference between the two groups (P < 0.001). There are 27 patients and 33 patients underwent conventional gastroscopy in the PE group and CMP group because of poor visualization. The characteristics of the study population are shown in Table 1.

Table 1 Baseline characteristics of patients
Full size table

Gastric cleanliness

Table 2 presents the cleanliness results of the six major anatomical regions of the gastric cavity. The PE group had better cleanliness in each region compared to CMP group, and there were significant differences between the two groups.

Table 2 Comparison of gastric cleanliness scores between two groups
Full size table

Mucosal visualization

Table 3 provides the visibility results of the six major anatomical regions of the gastric mucosa. The PE group had better visibility in each region compared to CMP group, and there were significant differences between the two groups.

Table 3 Comparison of mucosal visualization scores between two groups
Full size table

Positive findings

As shown in Table 4, 71 and 75 patients were diagnosed with chronic gastritis, gastric polyps, gastric submucosal tumor, gastric cancer or gastric ulcer between two groups. In terms of the detection of positive lesions in the stomach, there was no statistically significant difference between the PE group (48.0%) and the CMP group (47.2%) (P > 0.05).

Table 4 Comparison of positive findings between two groups
Full size table

Safety outcomes

All patients swallowed the capsule without difficulty, and no adverse events were reported.

Discussion

This study is the first to investigate the effectiveness of positioning exercises in improving the image quality of MCE. MCE as a non-invasive examination method, exhibits better tolerance and compliance compared to traditional endoscopy, making it an important tool for early gastric cancer screening and diagnosis of gastric diseases [5, 18,19,20,21]. However, capsule endoscopy lacks the capabilities of irrigation and suction, making thorough preparation of the mucosal surface crucial. The diagnostic accuracy relies on the cleanliness of the gastric field of view and the visibility of the mucosa. Patients with poor visualization may require further traditional endoscopic examination (such as insufflation and direct mucosal irrigation), which increases the examination time and cost.

Before capsule endoscopy, patients are typically administered an appropriate dose of chymotrypsin granules and simethicone emulsion, among other defoaming and mucolytic agents [22]. However, in clinical practice, it has been observed that the anatomy and physiological structures of the stomach are also factors that influence the visibility. Simply administering medication to patients does not ensure sufficient contact with all parts of the gastric cavity, leading to suboptimal clarity and visibility within the gastric cavity [23]. Studies have shown that body positioning is associated with better visualization of the stomach, and repeated changes in position have been proven to enhance visibility and cleanliness in all regions of the stomach [24, 25]. However, repeated changes in body position can be uncomfortable for elderly patients and those with limited mobility. Additionally, it requires dedicated personnel to assist in patient repositioning on the examination bed to prevent falls or accidents during the process. Lai et al. reported a sensitivity of 92.0% in MCE when performed with the patient in a standing position [26]. Another study demonstrated that standing position achieved a visibility of 75% for gastric mucosa during MCE examination, with good gastric cleanliness (77.4%), good operability, and safety. However, the gastric examination time was longer (27.8 ± 8.3 min) compared to the patients who underwent positioning exercises in this study (21.29 ± 5.82 min) [27]. In this study, positioning exercises facilitated the distribution of defoaming and mucolytic agents to more areas within the gastric cavity, improving the visualization of different anatomical regions. The first set of movements may allowed the medication to cover the upper part of the gastric body and the cardia. The second set of movements to cover the posterior wall of the gastric body. The third set of movements to cover the lesser curvature, greater curvature. The fourth set of movements to cover the antrum and lower part of the gastric body. Positioning exercises changes the position of the medication and water in the gastric cavity due to the gravity. Based on the body transformation and gravity relationship, We believe that after oral defoaming and sufficient water, together with positioning exercises, the medication can fully cover the antrum, the middle and lower part of the gastric body. Only first set of movements may not make the medication fully cover the upper part of gastric body and cardia, but through the whole movements can promote the peristalsis of the stomach, which may promote the medication to reach and makes the gastric contents discharged faster. Actually, that was difficult to accurately assess, and needs confirmed by more complete prospective studies.

A study by Wang et al. showed that repeating left lateral decubitus, supine, and right lateral decubitus positions for 15 min after taking dimethyl silicone oil significantly improved the cleanliness score of MCE (21.2 ± 1.0), which is comparable to the findings in this study (19.52 ± 2.26) [6]. However, positioning exercises are a more convenient and feasible activity, as most patients can follow the instructions to complete the exercises. It requires less preparation time and reduces waiting time for doctors, thus improving examination efficiency.

In this study, the positioning exercises group exhibited similar levels of image clarity and visibility in comparison to the study conducted by Zhu et al. [7], using water, simethicone, and pronase. The cleanliness score (19.52 ± 2.26) in the PE group was superior to that of the CMP group (15.89 ± 2.82), and the visibility score (15.09 ± 2.31) was also higher than that of the CMP group (10.93 ± 2.12). Furthermore, the PE group demonstrated good visibility and clarity scores in all six anatomical regions. Additionally, the PE group reduced the overall examination time (21.29 ± 5.82 min), and no additional complications or adverse events were reported during the examination. However, there was no significant difference in the detection of positive lesions between the two groups, which may be associated with the smaller sample size and warrants further studies with higher statistical power to confirm.

This study has several limitations. Firstly, as a single-center retrospective study, further large-scale prospective studies are needed for confirmation. Secondly, the number of patients included in the analysis is still relatively small, and increasing the sample size is required to minimize potential statistical bias. Thirdly, the pre-activity and activity-related physical conditions of the patients were not standardized and assessed.In addition, our study is the first to investigate the effectiveness of positioning exercises in improving the image quality of MCE. And this study set up special personnel to educate patients on positioning exercises, and the patients’ compliance was good.

Conclusion

Good pre-examination gastric preparation is crucial for ensuring image clarity and improving the detection rate of lesions. Our study confirms that positioning exercises performed by patients before MCE examination can reduce examination time and improve the quality of gastric mucosal images. Positioning exercises may serve as a standardized preparation activity prior to MCE examinations.

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

MCE:

Magnetic-controlled Capsule Endoscopy

CMP group:

The conventional medication preparation group

PE group:

The positioning exercises group

GET:

Gastric Examination Time

BMI:

Body Mass Index

SD:

Standard Deviation

References

  1. Rey JF, Ogata H, Hosoe N, et al. Blinded nonrandomized comparative study of gastric examination with a magnetically guided capsule endoscope and standard videoendoscope. Gastrointest Endosc. 2012;75:373–81.

    Article  PubMed  Google Scholar 

  2. Wang X, Hu X, Xu Y, Yong J, Li X, Zhang K, Gan T, Yang J, Rao N. A systematic review on diagnosis and treatment of gastrointestinal diseases by magnetically controlled capsule endoscopy and artificial intelligence. Th Adv Gastroenterol. 2023;16:17562848231206991.

    Article  Google Scholar 

  3. Pennazio M, Spada C, Eliakim R, Keuchel M, May A, Mulder CJ, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of gastrointestinal endoscopy (ESGE) clinical guideline. Endoscopy. 2015;47:352–76.

    Article  PubMed  Google Scholar 

  4. Hale MF, Rahman I, Drew K, Sidhu R, Riley SA, Patel P, et al. Magnetically steerable gastric capsule endoscopy is equivalent to flexible endoscopy in the detection of markers in an excised porcine stomach model: results of a randomized trial. Endoscopy. 2015;47:650–3.

    Article  PubMed  Google Scholar 

  5. Geropoulos G, Aquilina J, Kakos C, Anestiadou E, Giannis D. Magnetically controlled capsule endoscopy versus conventional gastroscopy: a systematic review and meta-analysis. J Clin Gastroenterol. 2021;55(7):577–85.

    Article  PubMed  Google Scholar 

  6. Wang YC, Pan J, Jiang X, Su XJ, Zhou W, Zou WB, Qian YY, Chen YZ, Liu X, Yu J, Yan XN, Zhao AJ, Li ZS, Liao Z. Repetitive position change improves gastric cleanliness for magnetically controlled capsule gastroscopy. Dig Dis Sci. 2019;64(5):1297–304.

    Article  PubMed  Google Scholar 

  7. Zhu SG, Qian YY, Tang XY, et al. Gastric preparation for magnetically controlled capsule endoscopy: a prospective, randomized singleblinded controlled trial. Dig Liver Dis. 2018;50(1):42–7.

    Article  PubMed  Google Scholar 

  8. Teh JL, Shabbir A, Yuen S, So JB. Recent advances in diagnostic upper endoscopy. World J Gastroenterol. 2020;26(4):433–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Li J, Wang L, Hu W, Wu J, Chen H, Wang L, Lv B, Zhang X, Dai Y, Huang Z, Cai Z, Ding X, Ye L, Ding J, Xiang L, Ye B, Chen S, Si J. Effect of premedication with pronase before upper gastrointestinal endoscopy: a multicenter prospective randomized controlled study. J Clin Gastroenterol. 2024;58(1):53–6.

    Article  CAS  PubMed  Google Scholar 

  10. Zhang Y, Zhang Y, Huang X. Development and application of magnetically controlled capsule endoscopy in detecting gastric lesions. Gastroenterol Res Pract. 2021;2021:2716559.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cao L, Zheng F, Wang D, Chen L, Feng X, Zhou Z, Liu J, Wang M, Guo Q, Liu M. The effect of using premedication of simethicone/pronase with or without postural change on visualization of the mucosa before endoscopy: a prospective, double blinded, randomized controlled trial. Clin Transl Gastroenterol. 2024;15(2):e00625.

    Article  PubMed  Google Scholar 

  12. Zou WB, Hou XH, Xin L, Liu J, Bo LM, Yu GY, et al. Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial. Endoscopy. 2015;47:525–8.

    Article  PubMed  Google Scholar 

  13. Liao Z, Hou X, Lin-Hu EQ, Sheng JQ, Ge ZZ, Jiang B, et al. Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases. Clin Gastroenterol Hepatol. 2016;14:1266–e731.

    Article  PubMed  Google Scholar 

  14. Li J, Ren M, Yang J, Zhao Y, Li Y, Zhang D, Wu F, Zhang Z, Lu X, Ren L, He S, Lu G. Screening value for gastrointestinal lesions of magnetic-controlled capsule endoscopy in asymptomatic individuals. J Gastroenterol Hepatol. 2021;36(5):1267–75.

    Article  PubMed  Google Scholar 

  15. Jiang X, Pan J, Li ZS, Liao Z. Standardized examination procedure of magnetically controlled capsule endoscopy. VideoGIE. 2019;4(6):239–43.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Neale JR, James S, Callaghan J, Patel P. Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study. Eur J Gastroenterol Hepatol. 2013;25(7):778–83.

    Article  CAS  PubMed  Google Scholar 

  17. Kuo C,Sheu B,Kao A, et al. A defoaming agent should be used with pronase premedication to improve visibility in upper gastrointestinal endoscopy. Endoscopy. 2002;34(7):531–4.

  18. Cheng CS, Sun TJ, Zhang HD. Human gastric magnet-controlled capsule endoscopy conducted in a standing position: the phase 1 study. BMC Gastroenterol. 2019;19(1):184.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hu J, Wang S, Ma W, Pan D, Sun S. Magnetically controlled capsule endoscopy as the first-line examination for high-risk patients for the standard gastroscopy: a preliminary study. Scand J Gastroenterol. 2019;54(7):934–7.

    Article  PubMed  Google Scholar 

  20. Liu YW, Wang YC, Zhu JH, Jiang X, Zhou W, Zhang J, Liao Z, Linghu EQ. Magnetically controlled capsule endoscopy in one-time gastro-small intestinal joint examination: a two-centre experience. BMC Gastroenterol. 2022;22(1):222.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hu J, Wang X, Sun S. Comparison between the widely used magnetically controlled capsule gastroscopy and conventional gastroscopy: a meta-analysis. Minim Invasive Ther Allied Technol. 2022;31(4):496–504.

    Article  PubMed  Google Scholar 

  22. Ching HL, Hale MF, Kurien M, et al. Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia. Endoscopy. 2019;51:409–18.

    Article  PubMed  Google Scholar 

  23. Liu X,Guan CT,Xue LY, et al. Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy:a multicenter large sample randomized controlled double-blind study. Surg Endosc. 2018;32(8):3548–56.

    Article  PubMed  Google Scholar 

  24. Sun T, Cheng C, Zhang H. Optimizing the performance of magnetcontrolled capsule endoscopy based on radiological and gastroscopic modeling. Exp Ther Med. 2020;19:248–54.

    PubMed  Google Scholar 

  25. Wang YC, Pan J, Jiang X, et al. Repetitive position change improves gastric cleanliness for magnetically controlled capsule gastroscopy. Dig Dis Sci. 2019;64:1297–304.

    Article  PubMed  Google Scholar 

  26. Lai HS, Wang XK, Cai JQ, et al. Standing-type magnetically guided capsule endoscopy versus gastroscopy for gastric examination: multicenter blinded comparative trial. Dig Endosc. 2020;32:557–64.

    Article  PubMed  Google Scholar 

  27. ZHANG LY, LI WY, JI M, et al. Efficacy and safety of using premedication with simethicone/Pronase during upper gastrointestinal endoscopy examination with sedation: a single center, prospective, single blinded. Randomized Controlled Trial Dig Endoscopy. 2018;30(1):57–64.

    CAS  Google Scholar 

Download references

Acknowledgements

The authors thank all colleagues in the department of endoscopy of The First Affiliated Hospital of Xiamen University for their support of this work.

Funding

Not applicable.

Author information

Author notes

  1. Yun Dai, Yong-Sheng Zheng and Wei-Lin Yang have contributed equally to this work.

Authors and Affiliations

  1. Department of Endoscopy, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, No. 55, Zhenhai Road, Siming District, Xiamen, Fujian, 361003, China

    Yun Dai, Yong-Sheng Zheng, Wei-Lin Yang, Guang-Yi Chen, Jian-Hai Wu, Hong-Bin Zhang, Jin-Hai Chen, Guo-Xing Xu & Hai-Xing Wang

Authors
  1. Yun Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong-Sheng Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei-Lin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guang-Yi Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jian-Hai Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong-Bin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jin-Hai Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Guo-Xing Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hai-Xing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The study was devised and planned by Yun Dai, YS Zheng, WL Yang and HX Wang. WL Yang, YS Zheng, GX Xu and JH Wu downloaded patient clinical data.Yun Dai, JH Chen and HB Zhang carried out data analysis and prepared the manuscript.Yun Dai, YS Zheng and GY Chen drafted and critically revised the manuscript and was responsible for management of the project. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hai-Xing Wang.

Ethics declarations

Ethics approval and consents to participate

The study was approved by the Ethics Committee of the Institutional Review Board of The First Affiliated Hospital of Xiamen University. Written informed consent was obtained from all patients before performing MCE examinations.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dai, Y., Zheng, YS., Yang, WL. et al. Positioning exercises in improving the quality of magnetic-controlled capsule endoscopy. BMC Gastroenterol 24, 313 (2024). https://doi.org/10.1186/s12876-024-03405-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12876-024-03405-6

Keywords

BMC Gastroenterology

ISSN: 1471-230X

Contact us