Long-Term Impact of Capsule Endoscopy in Patients Referred for Iron-Deficiency Anemia
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Video capsule endoscopy (VCE) is recommended as the third diagnostic test for patients with iron-deficiency anemia (IDA) after a normal upper endoscopy and colonoscopy.
To study long-term outcomes after VCE in patients with IDA.
We performed a retrospective study of VCE studies performed at Stanford University Hospital or the VA Palo Alto Health Care System from 2002 to 2006. We assessed endoscopic or radiographic procedures performed post-CE and contacted patients by telephone in order to determine current medical status and potential resolution of anemia since the VCE.
We invited 153 patients to participate, and 82 (54%) patients agreed to enroll including 57 patients with IDA and 25 patients with overt gastrointestinal bleeding. The overt group received more transfusions pre-CE (P < 0.05). The mean follow-up time was 36 ± 16 months (median 33 months, range 14–67) in the IDA referral group and 40 ± 16 months (median 39 months, range 17–69) in the overt bleeding group (P = 0.3). Positive findings on VCE were detected in 35 (60%) and 15 (60%) patients in the IDA referral and overt groups, respectively (P= 1.0). Of the 35 patients in the IDA referral group with significant VCE findings, 15 underwent therapeutic procedures, while 20 were managed conservatively. Over the mean follow-up period, 23% of the IDA referral group and 22% of the overt group remained anemic (P = 0.30).
Most patients referred for VCE examination to evaluate IDA were no longer anemic at 36 months of follow-up, with or without therapeutic intervention.
- Lewis BS. Small intestinal bleeding. Gastroenterol Clin North Am. 1994;23:67–91.
- Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000;405:417. CrossRef
- Estevez E, Gonzalez-Conde B, Vazquez-Iglesias JL, et al. Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding. Eur J Gastroenterol Hepatol. 2006;18:881–888. CrossRef
- Fireman Z, Friedman S. Diagnostic yield of capsule endoscopy in obscure gastrointestinal bleeding. Digestion. 2004;70:201–206. CrossRef
- Apostolopoulos P, Liatsos C, Gralnek IM, et al. The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract. Endoscopy. 2006;38:1127–1132. CrossRef
- Saurin JC, Delvaux M, Gaudin JL, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy. 2003;35:576–584. CrossRef
- Saurin JC, Delvaux M, Vahedi K, et al. Clinical impact of capsule endoscopy compared to push enteroscopy: 1-year follow-up study. Endoscopy. 2005;37:318–323. CrossRef
- Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy. 2006;38:49–58. CrossRef
- Bresci G, Parisi G, Bertoni M, Tumino E, Capria A. The role of video capsule endoscopy for evaluating obscure gastrointestinal bleeding: usefulness of early use. J Gastroenterol. 2005;40:256–259. CrossRef
- Junquera F, Feu F, Papo M, et al. A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Gastroenterology. 2001;121:1073–1079. CrossRef
- Lewis BS, Salomon P, Rivera-MacMurray S, Kornbluth AA, Wenger J, Waye JD. Does hormonal therapy have any benefit for bleeding angiodysplasia? J Clin Gastroenterol. 1992;15:99–103. CrossRef
- Viazis N, Papaxoinis K, Vlachogiannakos J, Efthymiou A, Theodoropoulos I, Karamanolis DG. Is there a role for second-look capsule endoscopy in patients with obscure GI bleeding after a nondiagnostic first test? Gastrointest Endosc. 2009;69:850–856. CrossRef
- Jones BH, Fleischer DE, Sharma VK, et al. Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2005;100:1058–1064. CrossRef
- Fry LC, Bellutti M, Neumann H, Malfertheiner P, Monkemuller K. Incidence of bleeding lesions within reach of conventional upper and lower endoscopes in patients undergoing double-balloon enteroscopy for obscure gastrointestinal bleeding. Aliment Pharmacol Ther. 2009;29:342–349. CrossRef
- Long-Term Impact of Capsule Endoscopy in Patients Referred for Iron-Deficiency Anemia
Digestive Diseases and Sciences
Volume 55, Issue 3 , pp 703-708
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
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- Capsule endoscopy
- Iron-deficiency anemia
- Gastrointestinal hemorrhage
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine and Division of Gastroenterology, Stanford University School of Medicine, Stanford, CA, USA
- 2. Division of Gastroenterology, Palo Alto VA Medical Center, Palo Alto, CA, USA
- 3. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, A149, 300 Pasteur Drive, Stanford, CA, 94305-5202, USA