de Silva, S.; Suggett, N.; Cockel, R.; Ismail, T.; Pathmakanthan, S.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA115
Academic Journal
Background: Capsule endoscopy is a novel endoscopic technology allowing complete wireless examination of bowel previously beyond visualisation of push enteroscopy or enteroclysis. Aims and Methods: This study examined the indications for capsule endoscopy in an initial cohort from our practice and its effect on subsequent patient management of small bowel pathology and obscure or occult gastrointestinal bleeding. All patients had prior endoscopic evaluation of the upper and lower gastrointestinal tract without diagnosis. Patients swallowed a disposable M2A imaging capsule (Given Imaging Ltd) that transmitted signals to an attached recorder. A total of 14 patients (9 female, 5 male, age range 30-69 years) were investigated. 10 patients (71%) were referred for investigation of obscure Gl blood loss and 4 for investigation of malabsorption in coeliac disease (1), persistent nausea and vomiting (1), persistent diarrhoea (1), and to identify a possible gastrointestinal source for Streptococcus bovi infection (1). Results: All the patients were able to swallow the capsule without any difficulty and tolerated the procedure well. The capsule was retrieved in all patients and the average transit time was 5 hours. Of the 14 procedures carried out 5 were abnormal (36%). 4 (40%) patients referred with obscure Gl bleeding had a source of bleeding identified. 2 received definitive treatment involving surgical resection of small bowel haemangiomas, and resection of a small bowel melanoma. Conclusion: Capsule endoscopy is safe and well tolerated by patients. It altered subsequent management in 40% of patients referred. We would recommend its use in selected patients after negative upper and lower gastrointestinal endoscopy where occult or obscure small intestinal bleeding is suspected.


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