title: Is it worthwhile to perform capsule endoscopy for asymptomatic patients with positive immunochemical faecal occult blood test?
abstract: BACKGROUND
  The immunochemical faecal occult blood test (IFOBT) is widely performed for colorectal cancer screening, but the usefulness of IFOBT in the detection of disorders of the small intestine is unknown. The objective of this study was to investigate what proportion of IFOBT-positive subjects with negative colonoscopy and oesophagogastroduodenoscopy has pathologies of the small intestine detected by capsule endoscopy (CE).
  
  
  METHODS
  Between October 2008 and June 2010, asymptomatic IFOBT-positive patients with negative total colonoscopy and oesophagogastroduodenoscopy underwent CE. CE findings were classified into three categories: P0 (no abnormalities, or findings without potential for bleeding), P1 (findings with uncertain potential for bleeding), P2 and (findings with high potential for bleeding).
  
  
  RESULTS
  Fifty-three patients (37 males, 16 females; 52.1 ± 13.0 years) were included. There were no cases with P2, 19 cases with P1, and 34 cases with P0 (there were no abnormalities in 25 of 34 cases). As a result, lesions in the small intestine were detected in 28 cases. Additional examination was considered necessary for five patients after CE, but no abnormality was detected, and therapeutic intervention was not undertaken in any case. Caecal completion rate was 92.5%.
  
  
  CONCLUSIONS
  No significant pathologies of the small intestine were detected in asymptomatic IFOBT-positive cases with negative colonoscopy and oesophagogastroduodenoscopy. CE is of limited use in asymptomatic patients with positive IFOBT.
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-Ku, Tokyo 141-8625, Japan. chiki1979@hotmail.com
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Chiba
authors.forename: Masau
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ito
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Ken
authors.initials: K
authors.lastname: Ohata
authors.forename: Akiko
authors.initials: A
authors.lastname: Ohno
authors.forename: Shotaro
authors.initials: S
authors.lastname: Umezawa
authors.forename: Suguru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Kantaro
authors.initials: K
authors.lastname: Hisatomi
authors.forename: Takuma
authors.initials: T
authors.lastname: Teratani
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis*; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D011237:Predictive Value of Tests; D011446:Prospective Studies