title: Capsule endoscopy in the investigation of patients with portal hypertension and anemia.
abstract: BACKGROUND
  Data on small bowel abnormalities in patients with portal hypertension (PHT) are limited. Bleeding from the gastrointestinal tract and anemia are common complications in these patients. Capsule endoscopy (CE) was used to evaluate small bowel (SB) pathology in patients with PHT and anemia, and possible associations with various parameters were examined.
  
  
  METHODS
  Thirty-five patients with PHT referred for CE investigation of the SB for anemia were prospectively enrolled in the study, as well as 70 age- and sex-matched control patients with anemia, normal liver function and no evidence of PHT who underwent CE.
  
  
  RESULTS
  Findings compatible with portal hypertensive enteropathy (PHE) were detected in 65.7% of the patients and in 15.7% of the controls chi2=26.641, P=0.000). Abnormalities in PHT patients included varices in 25.7%, diffuse changes of mucosa with inflammatory-like appearance in 42.9%, and angiodysplasias and/or spider angiomas in 22.9% of cases. The presence of PHE was significantly associated only with the presence of severe portal hypertensive gastropathy, while the presence of SB varices alone was significantly associated with the presence of severe portal hypertensive gastropathy, larger esophageal varices and the presence of colonic varices.
  
  
  CONCLUSIONS
  Varices, diffuse changes of mucosa with inflammatory-like appearance, and angiodysplasias and/or spider angiomas are detected more often in patients with PHT than in controls, and probably constitute the endoscopic characteristics of PHE. CE of the SB added a significant number of likely important findings to those detected by conventional endoscopic techniques for the clinical management of patients with PHT and anemia.
authors.affiliation: Department of Gastroenterology, Faculty of Nursing, Athens University, General Hospital of Athens Helena Venizelou, Athens, Greece.
authors.forename: Spyros
authors.initials: S
authors.lastname: Goulas
authors.forename: Konstantina
authors.initials: K
authors.lastname: Triantafyllidou
authors.forename: Stephanos
authors.initials: S
authors.lastname: Karagiannis
authors.forename: Panayiota
authors.initials: P
authors.lastname: Nicolaou
authors.forename: Petros
authors.initials: P
authors.lastname: Galanis
authors.forename: Irene
authors.initials: I
authors.lastname: Vafiadis
authors.forename: Michael
authors.initials: M
authors.lastname: Tzivras
authors.forename: Christos
authors.initials: C
authors.lastname: Mavrogiannis
mesh_terms: D000740:Anemia / Q000209:etiology* / Q000473:pathology*; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors