title: Capsule endoscopy findings in patients with occult or overt bleeding older than 80 years.
abstract: BACKGROUND
  Overt and occult bleeding are the main indications for a wireless capsule endoscopy (WCE) study of the small bowel. Most published studies omit patients aged over 80.
  
  
  OBJECTIVE
  To determine whether WCE is feasible in patients with overt or occult bleeding over age 80 and to define the spectrum of small bowel pathologies in this age group.
  
  
  METHODS
  In a retrospective non-randomized tertiary care study, 60 patients at least 80 years or older (aged group) and 120 matched patients aged <80 years (younger group) with overt or occult bleeding (including iron deficiency anaemia) and no significant gastroscopic or colonoscopic findings underwent WCE.
  
  
  RESULTS
  Of the 180 patients, 46 (77%) patients in the aged group and 97 (81%) in the younger group successfully completed small bowel study (P = 0.51). There was no difference in gastric transit time and small bowel passing time between the two groups. More patients in the aged group (48 cases, 80%) than the younger group (56 cases, 47%) presented with small bowel angiodysplasias (P < 0.0001). Nevertheless, there was no difference between the two groups concerning ulcerative and neoplastic lesions. No patient presented with capsule impaction, but more patients in the aged group (35 cases, 58%) than in the younger group (10 cases, 8%) found the study difficult and tiresome (P < 0.001). Preparation validation was poor in 34% of small bowel lumen in the aged group and 19% in the younger group (P = 0.03).
  
  
  CONCLUSIONS
  WCE is feasible, although rather tiresome, in patients over the age of 80. Though the vast majority of patients older than 80 presented with angiodysplasias, there were no differences between the aged and younger groups in the presence of ulcerative lesions and polyps or tumors.
authors.affiliation: Department of Gastroenterology, NIMTS General Hospital, 29 Biskini Str, Zografou, Athens, Greece. tsibofam@yahoo.com
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsibouris
authors.forename: Chrissostomos
authors.initials: C
authors.lastname: Kalantzis
authors.forename: Periklis
authors.initials: P
authors.lastname: Apostolopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Alexandrakis
authors.forename: Panagiota
authors.initials: P
authors.lastname: Mavrogianni
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kalantzis
mesh_terms: D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D005773:Gastroscopy; D006115:Greece; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors