The role of video capsule endoscopy in the evaluation of iron deficiency anaemia

Abstract Background Few studies have examined the diagnostic yield of video capsule endoscopy (VCE) in patients with iron deficiency anaemia (IDA). This retrospective study aims to identify the yield of VCE, distribution of VCE findings in IDA and factors predictive of positive findings among patients presenting to a gasteroendoscopy practice in regional Australia. Methods Findings of consecutive VCE studies between March 2017 and April 2020 performed in patients with unexplained IDA and negative conventional endoscopy were included in this retrospective analysis. All endoscopies were performed and reported by a single specialist physician. Relevant clinical data including demographics, medication use, haemoglobin and ferritin levels were extracted into a standardised spreadsheet with procedural findings. A positive diagnostic yield was considered when VCE diagnosed one or more lesions that could explain the IDA. Statistical analysis was used to determine variables correlated with definite VCE findings. Results In total 123 procedures were included. Mean age of the patients was 67.9 years. Mean haemoglobin and ferritin levels were 93.3 g/L and 11.9ug/L, respectively. Positive findings were present in 54.5% of patients with the most frequent finding being angiodysplasia (52.2%). Haemoglobin level was the only variable associated with a positive finding. A significant number of studies had significant findings outside the small bowel (41.8%), overwhelmingly within reach of conventional upper endoscopy (89.3%). Conclusions VCE is a valuable diagnostic modality in patients with IDA. Low haemoglobin was associated with a positive finding on VCE in this group of patients.

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The Utility of Capsule Endoscopy in Patients under 50 Years of Age with Recurrent Iron Deficiency Anaemia: Is the Juice Worth the Squeeze?

Gastroenterology Research and Practice ◽

10.1155/2015/948574 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Prabhjot Singh Sidhu ◽

Mark E. McAlindon ◽

Kaye Drew ◽

Reena Sidhu

Keyword(s):

Iron Deficiency ◽

Capsule Endoscopy ◽

Iron Deficiency Anaemia ◽

Significant Proportion ◽

Deficiency Anaemia ◽

Significant Pathology ◽

The Mean ◽

Group 2 ◽

Group 1

Background and Aims. The role of capsule endoscopy (CE) in the <50 years of age patients with iron deficiency anaemia (IDA) remains unclear. We aim to assess its utility in this cohort.Methods. All patients referred for CE for recurrent IDA were included retrospectively. Patients were divided into Group 1 (<50 years) and Group 2 (≥50 years).Results. There were 971 patients with recurrent IDA and 28% belonged to Group 1. The mean age was 40 years in this group with a DY of 28% (n=76). Significant diagnoses included erosions and ulcers (26%;n=71), small bowel (SB) angioectasia (AE) (10%;n=27), SB tumours (3%;n=7), Crohn’s disease (3%;n=7), SB bowel strictures (1%;n=3), and SB varices (1%;n=2). On logistic regression, the presence of diabetes (P=0.02) and the use of warfarin (P=0.049) was associated with increased DY. The DY in Group 2 was 38% which was significantly higher than in Group 1 (P=0.02). While SB tumours were equally common in both groups, AE was commoner in Group 2 (P<0.001).Conclusion. A significant proportion of patients <50 years are referred for CE. Although the DY is lower compared to those ≥50 years, significant pathology is found in this age group. CE is advisable in patients <50 years old with recurrent IDA and negative bidirectional endoscopies.

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