The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient

Anastasios Koulaouzidis*, Diana E. Yung, Jeff H. P. Lam, Alexandros Smirnidis, Sarah Douglas, John N. Plevris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background & aim. The role of Small-Bowel Capsule Endoscopy (SBCE) in Iron Deficiency Anemia (IDA) alone is still under validation. We aim to assess the usefulness of SBCE in patients with IDA alone; Methods. Retrospective study; patients with IDA (no GI symptoms or known previous diagnosis), who underwent SBCE were included. SBCE findings were classified as clinically significant/sinister (small-bowel malignancy, significant/sinister inflammation and/or strictures and coeliac disease) or vascular, i.e., signifcant/angioectasias (P1/P2 lesions); Results. A total of 221 (151F/70M) patients had SBCE for IDA as the sole indication. The diagnostic yield (DY) was 30.7% (68/221). The DY for significant/sinister pathology and significant/angioectasias was 9% and 21.7%, respectively. In those 40-year group (201; 138F/63M), significant/sinister pathology was found in 7.5% (15/201), p = 0.0231. None of the patients 40 years, p = 0.009. Fifty percent of those >80 years (16; 12F/4M) had angioectasias, but none had significant/sinister pathology (p = 0.0126). On multiple regression analysis, only prior blood transfusion was predictive of higher DY in SBCE; Conclusions. IDA alone is one of the main indications (27%) for referral to SBCE; the majority of patients are >40 years. In our cohort, the DY of SBCE for IDA was 30.7% and the commonest finding was angioectasias. The detection rate of sinister small-bowel pathology for those >40 years is low decreasing to zero in the >80 age group. In contrast, 25% of those

Original languageEnglish
Pages (from-to)1094-1100
Number of pages7
JournalScandinavian Journal of Gastroenterology
Volume47
Issue number8-9
DOIs
Publication statusPublished - Sep 2012

Keywords

  • endoscopy-general
  • GI-bleeding
  • IBD-clinical
  • small-intestinal-disorders
  • DOUBLE-BALLOON ENTEROSCOPY
  • GASTROINTESTINAL-TRACT
  • METAANALYSIS
  • DISEASE
  • ADULTS
  • YIELD

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