A new meta-analysis of 10 studies involving 4,374 patients examined why colon capsule endoscopy (CCE) remains limited by incomplete exams and inadequate bowel preparation. The study found that chronic opioid use and diabetes were key patient-level factors affecting CCE performance. Opioid use was associated with lower odds of completing the procedure and achieving adequate bowel preparation, while diabetes was linked to 60% lower odds of adequate preparation.
Overall, CCE completion was 73%, adequate bowel preparation was 72%, and successful CCE was 64%, while 61% of patients required follow-up endoscopy. The authors suggest that better patient selection could help reduce duplicate procedures and improve the cost-effectiveness of capsule-based colorectal evaluation.