A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding

Abstract

Our results demonstrate the superiority of CE in detecting abnormal lesions, and the superiority of DBE in endoscopic management.

Present status and strategy of NSAIDs-induced small bowel injury

“…Thus, the incidence of small-intestinal mucosal injury was clearly increased in rheumatoid arthritis patients who used NSAIDs. At our hospital (Osaka Medical College Hospital), we found that approximately 10.3% had small-bowel injuries associated with NSAIDs among patients who received VCE or BE for obscure gastrointestinal bleeding (OGIB) ( Table 1), compatible with other reports [2]. With the ease of small intestine examination, we are beginning to see a relatively high incidence of small-intestinal mucosal injuries due to NSAIDs, and measures for remedying such injuries have become urgent.…”

“…BE was superior to VCE in the diagnosis of relatively large lesions as polyps. On the other hand, small lesions such erosions and red spots were more often detected by VCE than BE [2]. In addition, we do not know which is higher, the detection ability of biomarkers or that of endoscopy.…”

“…Recently, the serious problem of NSAIDs-induced small intestinal damage has become a topic of great interest to gastroenterologists, since video capsule endoscopy (VCE) and balloon enteroscopy (BE) are available for the detection of small intestinal lesions [2][3][4]. Such lesions have been of great concern in clinical settings, and their treatment and prevention must be devised as soon as possible.…”

What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?

“…Guidelines developed by Gerson et al are presented here as an example. [8][9][10][11][12][13][14][15][16][17][18] Our algorithm is shown in Figure 5.…”

Videocapsule Endoscopy of the Small Bowel

“…General consensus today is that early diagnosis by CE can be followed by DBE findings, combined with interventional enteroscopy by the same method. (Kameda N et al, 2008;Marmo R et al, 2007) 6.2 Capsule endoscopy in Crohn's disease In Crohn's disease, patients often experience pain, diarrhea and weight loss, non-specific symptoms that do not correlate with the negative results from usual imaging investigations. (Kornbluth A et al, 2005) A consensus panel suggested that further investigation by CE is useful when patients display at least two of these symptoms.…”