title: Fecal immunochemical test and small bowel lesions detected on capsule endoscopy:  results of a prospective study in patients with obscure occult gastrointestinal bleeding.
abstract: BACKGROUND
  Fecal immunochemical test (FIT) is gaining popularity as a screening tool for colorectal cancer. The introduction of capsule endoscopy (CE) enables an assessment of the relationship between small bowel (SB) lesions and FIT results.
  
  
  OBJECTIVE
  To determine whether SB lesions found by CE are associated with an increased rate of positive FIT.
  
  
  METHODS
  Consecutive patients undergoing CE for obscure occult gastrointestinal bleeding also underwent FIT. CE was performed using the PillCam SB and FIT was performed with OC-Micro (three samples, threshold 75 and 100 ng/ml).
  
  
  RESULTS
  Fifty-one patients were included; the mean lowest hemoglobin was 9.1 ± 2.1 g/dl. Twenty-six patients (51.0%) had SB lesions identified by CE and were classified as the probable or suspected source of bleeding. At the threshold of 75 and 100 ng/ml, 12 of 26 (46.1%) and 10 of 26 (38.4%), respectively had a positive FIT. In contrast, only two of 25 (8.0%) patients without SB lesions had a positive FIT at both thresholds (P=0.002 and 0.010 respectively). The mean fecal hemoglobin in patients with SB lesions classified as probable or suspected source of bleeding versus patients with normal SB was 345.6 ± 773 and 25.0 ± 37.7 ng/ml, respectively (P=0.025).
  
  
  CONCLUSIONS
  A positive FIT can be explained by significant SB lesions detected by CE. Further studies are still needed to evaluate whether asymptomatic patients with positive FIT and nonexplanatory colonoscopy should undergo further study of the SB.
authors: Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Israel. zohar_levi@012.net.il
authors: Zohar
authors: Z
authors: Levi
authors: Eyal
authors: E
authors: Gal
authors: Alex
authors: A
authors: Vilkin
authors: Yafit
authors: Y
authors: Chonen
authors: Rachel Gingold
authors: RG
authors: Belfer
authors: Gerald
authors: G
authors: Fraser
authors: Yaron
authors: Y
authors: Niv
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology; D053704:Capsule Endoscopy / Q000379:methods*; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007120:Immunochemistry / Q000379:methods*; D007410:Intestinal Diseases / Q000150:complications / Q000175:diagnosis*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins