The role of capsule endoscopy in the diagnosis and treatment of obscure gastrointestinal bleeding in older individuals.
OBJECTIVE
Capsule endoscopy (CE) is currently recommended as the first-line diagnostic modality for the investigation of obscure gastrointestinal bleeding (OGIB). This study aimed to evaluate the diagnostic efficacy of CE and to determine the subsequent impacts on the treatment of the OGIB episode in older individuals.


METHODS
Eight hundred and fifty-three patients who underwent CE for the indication of OGIB were investigated in a single center between January 2004 and December 2015. Patients were divided into two groups: those 65 years of age and older and those younger than 65 years of age.


RESULTS
There were no significant differences between older patients and younger patients with respect to the CE completion rate. The diagnostic yield was significantly higher in older patients than in younger patients (55.1 vs. 46.6%, P=0.021). Vascular lesions were the main cause of bleeding in the elderly, whereas ulcerated/erosive lesions were found most frequently in younger patients. Furthermore, 56.0% of older patients with positive CE results had relevant changes in their management plans and received specific treatment on the basis of CE findings.


CONCLUSIONS
Our study confirmed the important role of CE in the diagnosis of OGIB and its huge impact on decision making in the management plan for older patients.
Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Lan
L
Li
Chunxiao
C
Chen
Youming
Y
Li
Bingling
B
Zhang
D000328:Adult; D000367:Age Factors; D000368:Aged; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D053704:Capsule Endoscopy / Q000379:methods*; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis; D014456:Ulcer / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*
D000894:Anti-Inflammatory Agents, Non-Steroidal