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Published in: Digestive Diseases and Sciences 5/2007

01-05-2007 | Original Paper

Capsule Endoscopy Changes Patient Management in Routine Clinical Practice

Authors: Reena Sidhu, David S. Sanders, Kapil Kapur, David P. Hurlstone, Mark E. McAlindon

Published in: Digestive Diseases and Sciences | Issue 5/2007

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Abstract

Our objective was to evaluate the diagnostic yield and effect of capsule endoscopy on patient management in routine clinical practice. Three hundred examinations were performed (176 females; mean age, 51 years), with a median follow-up of 17 months. Indications included overt bleeding (n = 55), anemia (n = 104), suspected Crohn’s disease (n = 68), celiac disease (n = 35), suspected functional symptoms (n = 23), polyposis (n = 5), and miscellaneous (n = 10). The overall diagnostic yield was 39%, but it was notably higher in overt bleeders, 66%, compared to 46% in the anemia group (P<0.025), 32% in the suspected Crohn’s group (P<0.001), and 17% in the functional group (P<0.001). As a result of capsule endoscopy, management was altered in 26% of patients. This study shows that capsule endoscopy has both a high diagnostic yield and an impact on subsequent patient management. These data further support the role of capsule endoscopy in routine clinical practice.
Literature
1.
go back to reference Adler DG, Knipschield M, Gostout C (2004) A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 59:492–498PubMedCrossRef Adler DG, Knipschield M, Gostout C (2004) A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 59:492–498PubMedCrossRef
2.
go back to reference Appleyard M, Glukhovsky A, Swain P (2001) Wireless-capsule diagnostic endoscopy for recurrent small-bowel bleeding. N Engl J Med 344:232–233PubMedCrossRef Appleyard M, Glukhovsky A, Swain P (2001) Wireless-capsule diagnostic endoscopy for recurrent small-bowel bleeding. N Engl J Med 344:232–233PubMedCrossRef
3.
go back to reference Pennazio M, Eisen G, Goldfarb N (2005) ICCE Consensus for Obscure Gastrointestinal Bleeding. Endoscopy 37:1046–1050PubMedCrossRef Pennazio M, Eisen G, Goldfarb N (2005) ICCE Consensus for Obscure Gastrointestinal Bleeding. Endoscopy 37:1046–1050PubMedCrossRef
4.
go back to reference Iddan GJ, Swain CP (2004) History and development of capsule endoscopy. Gastrointest Endosc Clin N Am 14:1–9PubMedCrossRef Iddan GJ, Swain CP (2004) History and development of capsule endoscopy. Gastrointest Endosc Clin N Am 14:1–9PubMedCrossRef
5.
go back to reference Korman LY, Delvaux M, Gay G, Hagenmuller F, Keuchel M, Friedman S, Weinstein M, Shetzline M, Cave D, de Franchis R (2005) Capsule Endoscopy Structured Terminology (CEST): proposal of a standardized and structured terminology for reporting capsule endoscopy procedures. Endoscopy 37:951–959PubMedCrossRef Korman LY, Delvaux M, Gay G, Hagenmuller F, Keuchel M, Friedman S, Weinstein M, Shetzline M, Cave D, de Franchis R (2005) Capsule Endoscopy Structured Terminology (CEST): proposal of a standardized and structured terminology for reporting capsule endoscopy procedures. Endoscopy 37:951–959PubMedCrossRef
6.
go back to reference Catassi C, Bearzi I, Holmes GK (2005) Association of celiac disease and intestinal lymphomas and other cancers. Gastroenterology 128:S79–S86PubMedCrossRef Catassi C, Bearzi I, Holmes GK (2005) Association of celiac disease and intestinal lymphomas and other cancers. Gastroenterology 128:S79–S86PubMedCrossRef
7.
go back to reference Enns R, Go K, Chang H, Pluta K (2004) Capsule endoscopy: a single-centre experience with the first 226 capsules. Can J Gastroenterol 18:555–558PubMed Enns R, Go K, Chang H, Pluta K (2004) Capsule endoscopy: a single-centre experience with the first 226 capsules. Can J Gastroenterol 18:555–558PubMed
8.
go back to reference Tatar EL, Shen EH, Palance AL, Sun JH, Pitchumoni CS (2006) Clinical utility of wireless capsule endoscopy: experience with 200 cases. J Clin Gastroenterol 40:140–144PubMedCrossRef Tatar EL, Shen EH, Palance AL, Sun JH, Pitchumoni CS (2006) Clinical utility of wireless capsule endoscopy: experience with 200 cases. J Clin Gastroenterol 40:140–144PubMedCrossRef
9.
go back to reference Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A, Kerstan E, Knoflach P, Schoefl R (2004) Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy 36:864–868PubMedCrossRef Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A, Kerstan E, Knoflach P, Schoefl R (2004) Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy 36:864–868PubMedCrossRef
10.
go back to reference Fireman Z, Eliakim R, Adler S, Scapa E (2004) Capsule endoscopy in real life: a four-centre experience of 160 consecutive patients in Israel. Eur J Gastroenterol Hepatol 16:927–931PubMedCrossRef Fireman Z, Eliakim R, Adler S, Scapa E (2004) Capsule endoscopy in real life: a four-centre experience of 160 consecutive patients in Israel. Eur J Gastroenterol Hepatol 16:927–931PubMedCrossRef
11.
go back to reference Qvigstad G, Hatlen-Rebhan P, Brenna E, Waldum HL (2006) Capsule endoscopy in clinical routine in patients with suspected disease of the small intestine: a 2-year prospective study. Scand J Gastroenterol 41:614–618PubMedCrossRef Qvigstad G, Hatlen-Rebhan P, Brenna E, Waldum HL (2006) Capsule endoscopy in clinical routine in patients with suspected disease of the small intestine: a 2-year prospective study. Scand J Gastroenterol 41:614–618PubMedCrossRef
12.
go back to reference Rastogi A, Schoen RE, Slivka A (2004) Diagnostic yield and clinical outcomes of capsule endoscopy. Gastrointest Endosc 60:959–964PubMedCrossRef Rastogi A, Schoen RE, Slivka A (2004) Diagnostic yield and clinical outcomes of capsule endoscopy. Gastrointest Endosc 60:959–964PubMedCrossRef
13.
go back to reference Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126:643–653PubMedCrossRef Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126:643–653PubMedCrossRef
14.
go back to reference De Leusse A, Landi B, Edery J, Burtin P, Lecomte T, Seksik P, Bloch F, Jian R, Cellier C (2005) Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement. Endoscopy 37:617–621PubMedCrossRef De Leusse A, Landi B, Edery J, Burtin P, Lecomte T, Seksik P, Bloch F, Jian R, Cellier C (2005) Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement. Endoscopy 37:617–621PubMedCrossRef
15.
go back to reference Saurin JC, Delvaux M, Gaudin JL, Fassler I, Villarejo J, Vahedi K, Bitoun A, Canard JM, Souquet JC, Ponchon T, Florent C, Gay G (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy 35:576–584PubMedCrossRef Saurin JC, Delvaux M, Gaudin JL, Fassler I, Villarejo J, Vahedi K, Bitoun A, Canard JM, Souquet JC, Ponchon T, Florent C, Gay G (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy 35:576–584PubMedCrossRef
16.
go back to reference Kerrigan DD, Brown SR, Hutchinson GH (1990) Open access gastroscopy: too much to swallow?. BMJ 300:374–376PubMedCrossRef Kerrigan DD, Brown SR, Hutchinson GH (1990) Open access gastroscopy: too much to swallow?. BMJ 300:374–376PubMedCrossRef
17.
go back to reference Kingston R, Byrnes G, O’Ceallaigh D (1999) Diagnostic yield of gastroscopy in a general surgical unit. Ir J Med Sci 168:268–270PubMed Kingston R, Byrnes G, O’Ceallaigh D (1999) Diagnostic yield of gastroscopy in a general surgical unit. Ir J Med Sci 168:268–270PubMed
18.
go back to reference Wai CT, Yeoh KG, Ho KY, Kang JY, Lim SG (2002) Diagnostic yield of upper endoscopy in Asian patients presenting with dyspepsia. Gastrointest Endosc 56:548–551PubMedCrossRef Wai CT, Yeoh KG, Ho KY, Kang JY, Lim SG (2002) Diagnostic yield of upper endoscopy in Asian patients presenting with dyspepsia. Gastrointest Endosc 56:548–551PubMedCrossRef
19.
go back to reference Morini S, Hassan C, Meucci G, Toldi A, Zullo A, Minoli G (2001) Diagnostic yield of open access colonoscopy according to appropriateness. Gastrointest Endosc 54:175–179PubMed Morini S, Hassan C, Meucci G, Toldi A, Zullo A, Minoli G (2001) Diagnostic yield of open access colonoscopy according to appropriateness. Gastrointest Endosc 54:175–179PubMed
20.
go back to reference Karajeh MA, Sanders DS, Hurlstone DP (2006) Colonoscopy in elderly people is a safe procedure with a high diagnostic yield: a prospective comparative study of 2000 patients. Endoscopy 38:226–230PubMedCrossRef Karajeh MA, Sanders DS, Hurlstone DP (2006) Colonoscopy in elderly people is a safe procedure with a high diagnostic yield: a prospective comparative study of 2000 patients. Endoscopy 38:226–230PubMedCrossRef
21.
go back to reference de Bosset V, Froehlich F, Rey JP, Thorens J, Schneider C, Wietlisbach V, Vader JP, Burnand B, Muhlhaupt B, Fried M, Gonvers JJ (2002) Do explicit appropriateness criteria enhance the diagnostic yield of colonoscopy? Endoscopy 34:360–368PubMedCrossRef de Bosset V, Froehlich F, Rey JP, Thorens J, Schneider C, Wietlisbach V, Vader JP, Burnand B, Muhlhaupt B, Fried M, Gonvers JJ (2002) Do explicit appropriateness criteria enhance the diagnostic yield of colonoscopy? Endoscopy 34:360–368PubMedCrossRef
22.
go back to reference Wexner SD, Garbus JE, Singh JJ (2001) A prospective analysis of 13,580 colonoscopies. Reevaluation of credentialing guidelines. Surg Endosc 15:251–261PubMedCrossRef Wexner SD, Garbus JE, Singh JJ (2001) A prospective analysis of 13,580 colonoscopies. Reevaluation of credentialing guidelines. Surg Endosc 15:251–261PubMedCrossRef
23.
go back to reference Munitz HA, Gelfand DW, Ott DJ (1985) Upper gastrointestinal series: patient management and a study of 199 cases. Gastrointest Radiol 10:277–281PubMedCrossRef Munitz HA, Gelfand DW, Ott DJ (1985) Upper gastrointestinal series: patient management and a study of 199 cases. Gastrointest Radiol 10:277–281PubMedCrossRef
24.
go back to reference Holdsworth CD, Bardhan KD, Balmforth GV, Dixon RA, Sladen GE (1979) Upper gastrointestinal endoscopy: its effects on patient management. Br Med J 1:775–777PubMedCrossRef Holdsworth CD, Bardhan KD, Balmforth GV, Dixon RA, Sladen GE (1979) Upper gastrointestinal endoscopy: its effects on patient management. Br Med J 1:775–777PubMedCrossRef
25.
go back to reference Hungin AP, Thomas PR, Bramble MG, Corbett WA, Idle N, Contractor BR, Berridge DC, Cann G (1994) What happens to patients following open access gastroscopy? An outcome study from general practice. Br J Gen Pract 44:519–521PubMed Hungin AP, Thomas PR, Bramble MG, Corbett WA, Idle N, Contractor BR, Berridge DC, Cann G (1994) What happens to patients following open access gastroscopy? An outcome study from general practice. Br J Gen Pract 44:519–521PubMed
26.
go back to reference Graham DJ, Pritchard TJ, Bloom AD (1993) Colonoscopy for intermittent rectal bleeding: impact on patient management. J Surg Res 54:136–139PubMedCrossRef Graham DJ, Pritchard TJ, Bloom AD (1993) Colonoscopy for intermittent rectal bleeding: impact on patient management. J Surg Res 54:136–139PubMedCrossRef
27.
go back to reference Mata A, Bordas JM, Feu F, Gines A, Pellise M, Fernandez-Esparrach G, Balaguer F, Pique JM, Llach J (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 20:189–194PubMedCrossRef Mata A, Bordas JM, Feu F, Gines A, Pellise M, Fernandez-Esparrach G, Balaguer F, Pique JM, Llach J (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 20:189–194PubMedCrossRef
28.
go back to reference Kalantzis N, Papanikolaou IS, Giannakoulopoulou E, Alogari A, Kalantzis C, Papacharalampous X, Gabriel P, Alexandrakis G, Apostolopoulos P (2005) Capsule endoscopy; the cumulative experience from its use in 193 patients with suspected small bowel disease. Hepatogastroenterology 52:414–419PubMed Kalantzis N, Papanikolaou IS, Giannakoulopoulou E, Alogari A, Kalantzis C, Papacharalampous X, Gabriel P, Alexandrakis G, Apostolopoulos P (2005) Capsule endoscopy; the cumulative experience from its use in 193 patients with suspected small bowel disease. Hepatogastroenterology 52:414–419PubMed
29.
go back to reference Selby W (2004) Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin? Gastrointest Endosc 59:782–787PubMedCrossRef Selby W (2004) Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin? Gastrointest Endosc 59:782–787PubMedCrossRef
30.
go back to reference Viazis N, Papaxoinis K, Theodoropoulos I, Sgouros S, Vlachogiannakos J, Pipis P, Markoglou C, Avgerinos A (2005) Impact of capsule endoscopy in obscure small-bowel bleeding: defining strict diagnostic criteria for a favorable outcome. Gastrointest Endosc 62:717–722PubMedCrossRef Viazis N, Papaxoinis K, Theodoropoulos I, Sgouros S, Vlachogiannakos J, Pipis P, Markoglou C, Avgerinos A (2005) Impact of capsule endoscopy in obscure small-bowel bleeding: defining strict diagnostic criteria for a favorable outcome. Gastrointest Endosc 62:717–722PubMedCrossRef
31.
go back to reference Kitiyakara T, Selby W (2005) Non-small-bowel lesions detected by capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc 62:234–238PubMedCrossRef Kitiyakara T, Selby W (2005) Non-small-bowel lesions detected by capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc 62:234–238PubMedCrossRef
32.
go back to reference Zaman A, Katon RM (1998) Push enteroscopy for obscure gastrointestinal bleeding yields a high incidence of proximal lesions within reach of a standard endoscope. Gastrointest Endosc 47:372–376PubMedCrossRef Zaman A, Katon RM (1998) Push enteroscopy for obscure gastrointestinal bleeding yields a high incidence of proximal lesions within reach of a standard endoscope. Gastrointest Endosc 47:372–376PubMedCrossRef
33.
go back to reference Hayat M, Axon AT, O’Mahony S (2000) Diagnostic yield and effect on clinical outcomes of push enteroscopy in suspected small-bowel bleeding. Endoscopy 32:369–372PubMedCrossRef Hayat M, Axon AT, O’Mahony S (2000) Diagnostic yield and effect on clinical outcomes of push enteroscopy in suspected small-bowel bleeding. Endoscopy 32:369–372PubMedCrossRef
34.
go back to reference Lewis BS, Eisen GM, Friedman S (2005) A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 37:960–965PubMedCrossRef Lewis BS, Eisen GM, Friedman S (2005) A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 37:960–965PubMedCrossRef
35.
go back to reference Bardan E, Nadler M, Chowers Y, Fidder H, Bar-Meir S (2003) Capsule endoscopy for the evaluation of patients with chronic abdominal pain. Endoscopy 35:688–689PubMedCrossRef Bardan E, Nadler M, Chowers Y, Fidder H, Bar-Meir S (2003) Capsule endoscopy for the evaluation of patients with chronic abdominal pain. Endoscopy 35:688–689PubMedCrossRef
36.
go back to reference Fleischer W, Leighton J, Sharma V, Heigh R (2003) Video capsule endoscopy is useful in the evaluation of patients with chronic abdominal pain. Gastroenterology 124:A245 (abstract)CrossRef Fleischer W, Leighton J, Sharma V, Heigh R (2003) Video capsule endoscopy is useful in the evaluation of patients with chronic abdominal pain. Gastroenterology 124:A245 (abstract)CrossRef
Metadata
Title
Capsule Endoscopy Changes Patient Management in Routine Clinical Practice
Authors
Reena Sidhu
David S. Sanders
Kapil Kapur
David P. Hurlstone
Mark E. McAlindon
Publication date
01-05-2007
Published in
Digestive Diseases and Sciences / Issue 5/2007
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-006-9610-6

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