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The use of small bowel capsule endoscopy in iron deficiency anaemia: low impact on outcome in the medium term despite high diagnostic yield.
- Source :
-
European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2013 Mar; Vol. 25 (3), pp. 327-32. - Publication Year :
- 2013
-
Abstract
- Introduction: Small bowel capsule endoscopy (SBCE) is a useful diagnostic modality in small bowel disorders. Iron deficiency anaemia (IDA) is one of the most common indications for SBCE. However, there are limited data on the diagnostic yield for IDA alone, and little is known about the clinical impact and long-term outcome of patients following SBCE.<br />Aim: To determine the diagnostic yield of SBCE in IDA and to examine outcome.<br />Materials and Methods: A retrospective review of a tertiary referral centre's database over a 21-month time period was carried out. Information on follow-up and management was obtained through chart review.<br />Results: In all, 309 SBCEs were identified, 30% (n=93) for anaemia and in 70% (n=65), follow-up data were available. The small bowel diagnostic yield for IDA was 53% (n=35), including angiodysplasia 49% (n=17), nonspecific inflammation 34% (n=12), active bleeding 11% (n=4) and Crohn's disease 6% (n=2). In addition, 16% (n=10) had abnormalities (gastritis, gastric antral vascular ectasia, duodenitis) outside the small bowel. In all, 42% (n=27) were persistently anaemic after a mean follow-up of 9.3 months. Of these, 52% (n=14) and 48% (n=13) had positive and negative SBCEs, respectively. In total, SBCE led to a change in treatment in 28 patients (44%), of whom 17 (61%) remained anaemic.<br />Conclusion: This study shows a high overall diagnostic yield for SBCE in IDA 71% (n=45). Despite the majority, 53% (n=24), of patients with positive tests receiving specific treatment, 61% (n=17) remained anaemic in the long term. SBCE results were not predictive of long-term outcome even when stratified for a change in management.
- Subjects :
- Adult
Aged
Aged, 80 and over
Anemia, Iron-Deficiency therapy
Angiodysplasia complications
Angiodysplasia diagnosis
Angiodysplasia therapy
Crohn Disease complications
Crohn Disease diagnosis
Crohn Disease therapy
Female
Gastrointestinal Hemorrhage complications
Gastrointestinal Hemorrhage diagnosis
Gastrointestinal Hemorrhage therapy
Humans
Intestinal Diseases complications
Intestinal Diseases therapy
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Tertiary Care Centers
Time Factors
Young Adult
Anemia, Iron-Deficiency etiology
Capsule Endoscopes statistics & numerical data
Intestinal Diseases diagnosis
Intestine, Small pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5687
- Volume :
- 25
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 23183118
- Full Text :
- https://doi.org/10.1097/MEG.0b013e32835b7d3a