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Video Capsule Endoscopy Has a Minor Long-term Therapeutic Impact on Patients with Iron Deficiency Anemia
Anton Bermont1,2, Daniel L Cohen1,2, Vered Richter1,2
1Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
Background:
One of the main causes of iron deficiency anemia (IDA) is chronic gastrointestinal blood loss. The use of video capsule endoscopy (VCE) after negative bidirectional endoscopy in patients with IDA is controversial.
Objectives:
To evaluate the effect of VCE in the management and long-term outcomes of IDA patients.
Methods:
A retrospective case-control study was performed on all patients with IDA undergoing VCE over a 5-year period. We compared those with positive findings on VCE to those with normal findings. All participants previously underwent a negative bidirectional endoscopy.
Results:
We performed 199 VCE examinations; median follow-up time was 4 years (IQR 2-5). Positive findings were identified in 66 patients (diagnostic yield 33.2%). Double balloon enteroscopy or push enteroscopy was performed in eight patients (18.6%); only one was therapeutic. The main therapy in both groups was iron supplementation. There were no significant differences in iron treatment before and after VCE in each group and between groups. Anemia improved in both groups. There was no difference in the level of hemoglobin change between the groups during each year of follow-up compared to the baseline level prior to VCE. Anemia resolved in 15 patients (35%) in the positive VCE group and in 19 (45%) in the negative VCE group (P = 0.33).
Conclusions:
Positive findings on VCE led to subsequent endoscopic interventions only in a small percentage of patients with IDA. Anemia improved and resolved equally whether or not there were VCE findings. The main intervention that appears to help IDA is iron supplementation.
Insights
Video capsule endoscopy (VCE) did not significantly alter anemia management or outcomes in iron deficiency anemia (IDA) patients. Iron supplementation remains the primary intervention for improving anemia in IDA.
Area of Science:
- Gastroenterology
- Hematology
Background:
- Chronic gastrointestinal blood loss is a primary cause of iron deficiency anemia (IDA).
- The utility of video capsule endoscopy (VCE) in IDA patients with prior negative bidirectional endoscopy is debated.
Purpose of the Study:
- To assess the impact of VCE on the management and long-term outcomes of patients diagnosed with IDA.
Main Methods:
- A retrospective case-control study analyzed IDA patients undergoing VCE after negative bidirectional endoscopy.
- Patients were stratified based on VCE findings (positive vs. normal).
- Outcomes were evaluated over a median follow-up of 4 years.
Main Results:
- VCE yielded positive findings in 33.2% of patients, but subsequent endoscopic interventions were infrequent.
- Iron supplementation was the predominant therapy in both VCE groups.
- Anemia improvement and resolution rates were similar between patients with positive and normal VCE findings.
Conclusions:
- VCE findings infrequently led to further endoscopic interventions in IDA patients.
- Anemia resolution and improvement were comparable regardless of VCE results.
- Iron supplementation is the key therapeutic strategy for managing IDA.
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