Control of capsule endoscopy (CE) movement remains challenging despite recent advances in magnetic navigation. Prolonged gastrointestinal (GI) transit time often limits complete examination, particularly in patients with reduced GI motility. 

An ingestible peristaltic stimulator (PS) may facilitate active propulsion of the capsule. 

(1) Electrical and pressure thresholds required to induce peristalsis in the terminal ileum and colon were measured during colonoscopy in 10 healthy volunteers (5 men, 5 women).(2) Two PS-CE prototypes (pressure-based and electrical) were evaluated in 5 patients after written informed consent. The PS balloon was automatically inflated or electrically activated at preset intervals during CE progression. Small-bowel transit time (SBTT) and large-bowel transit time (LBTT) were recorded.

Pressure-based stimulation required 75 ± 13 mmHg to induce peristalsis, whereas electrical stimulation required only 5 ± 3 µA, achievable with a coin battery or wireless power transfer. Peristaltic propagation averaged approximately 3 cm/s, and stimulation cycles were set below 0.2 Hz to respect the refractory period of Auerbach’s plexus.With PS assistance, SBTT was reduced from 207 ± 37 min to 46 ± 16 min, and LBTT from 684 ± 232 min to 37 ± 12 min.

 Although preliminary, electrical stimulation demonstrated markedly lower activation thresholds than pressure-based stimulation. Transit times are influenced by preparation quality and patient characteristics; thus, larger studies with matched controls and statistical validation are required. Development of wireless-powered PS devices without an onboard battery may further improve safety.

An ingestible electrical peristaltic stimulator appears feasible and may substantially shorten CE transit time. Further controlled trials are needed to establish safety, efficacy, and clinical utility.