Capsule endoscopy in the assessment of iron deficiency anaemia and obscure gastrointestinal bleeding

Introduction: Capsule endoscopy (CE) was introduced in the year 2000 for visualizing the gastrointestinal (GI) tract and since then it has played an important role in the assessment of patients with obscure GI bleeding (OGIB) and unexplained iron deficiency anaemia (IDA).

Methods: The aim of this study was to describe the usefulness of CE in the assessment of OGIB and IDA. We analysed the demographical and medical conditions of these patients and the diagnostic yield of CE and its impact on patient management.

Results: Of the 22 patients, 12 were male. Mean age was 50.7 (SD=19.6 years, Range= 20-81) years. The majority (n=11) referred were being investigated for unexplained iron deficiency anaemia. Other indications were, OGIB (n=6), melaena (n=4), malabsorption and IDA (n=1) and massive GI bleed (n=1). CE showed no abnormalities in 7, polyps and helminthiasis were identified in 2 patients each. Multiple other pathologies were also identified in the remaining. In 91.3 % (n=21) it provided new information and in 83.3% (n=20) it provided the information sought by the doctor. In 79.2% (n=19) it changed the management.

Conclusion: Though the cost of CE is significantly high compared to other GI investigations, the high diagnostic yield and its impact on patient management justified its use.

Key words: Anaemia; Obscure gastro intestinal bleeding; Capsule endoscopy.

DOI: http://dx.doi.org/10.4038/sljs.v29i1.3578

Sri Lanka Journal of Surgery 2011: 29(1) 23-27