title: Comparative evaluation of barium meal follow-through and barium enteroclysis before capsule endoscopy in obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  Small bowel radiological investigations have lower diagnostic yield in comparison to capsule endoscopy (CE) and are inaccurate in predicting capsule impaction. Most studies have used barium meal follow-through (BAMFT) and more sensitive barium enteroclysis (BE) is infrequently used. This study was done to retrospectively compare results of performing BAMFT or BE before CE in patients with obscure gastrointestinal bleeding.
  
  
  METHODS
  Sixtyfive patients with obscure gastrointestinal bleeding underwent barium examination (BE or BAMFT depending upon patient's preference) and CE was performed if barium examination was normal. The demographic data, barium examination results and CE findings were retrospectively collected.
  
  
  RESULTS
  Sixteen patients underwent BAMFT and 49 patients underwent BE prior to CE. BAMFT was normal in all 16 patients whereas CE was normal in only 1/16 patient. Seven of 49 (14.2%) patients had stricture or mass on BE. In these 7 patients CE was not performed. In contrast to BAMFT, 22/41 (53.6%) patients with normal BE had normal CE findings also. The capsule got stuck in one patient with NSAID induced diaphragm disease who had normal BE and required surgical removal.
  
  
  CONCLUSIONS
  BE should be preferred over BAMFT as the radiological imaging technique for evaluation of small bowel before CE in patients with obscure gastrointestinal bleeding as it may detect unexpected strictures and intraluminal masses. However, radiological findings either on BAMFT or BE cannot predict passage of capsule endoscope through small bowel.
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsurinderrana@yahoo.co.in
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Rana
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Bhasin
authors.forename: Birinder
authors.initials: B
authors.lastname: Nagi
authors.forename: Showkat A
authors.initials: SA
authors.lastname: Zargar
authors.forename: Nirmaljeet S
authors.initials: NS
authors.lastname: Malhi
authors.forename: Saroj K
authors.initials: SK
authors.lastname: Sinha
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D053704:Capsule Endoscopy; D003287:Contrast Media; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate