Patients on Antithrombotic Agents with Small Bowel Bleeding -Yield of Small Bowel Capsule Endoscopy and Subsequent...

Area of Science:

• Gastroenterology
• Endoscopy
• Internal Medicine

Background:

• Small bowel gastrointestinal bleeding (GIB) significantly impacts patient quality of life and healthcare resource utilization.
• Antithrombotic medications are frequently associated with an increased risk of small bowel GIB.

Purpose of the Study:

• To determine the diagnostic yield of small bowel capsule endoscopy (SBCE) in patients on antithrombotic therapy.
• To assess the impact of SBCE on the subsequent treatment course for small bowel GIB.

Main Methods:

• Retrospective review of electronic medical records for 1986 patients who underwent SBCE.
• Analysis of diagnostic yield based on antithrombotic medication use and inpatient vs. outpatient setting.

Main Results:

• Higher diagnostic yield for SBCE in detecting bleeding stigmata in patients on antiplatelet agents (21.6%) and anticoagulation (22.5%) compared to those not on these medications (12.1% and 13.5%, respectively).
• Inpatient SBCE showed a higher diagnostic yield (21.8%) than outpatient SBCE (12%).
• SBCE findings led to further endoscopic evaluation in 25.2% of positive cases, with hemostasis attempted in 52.5%.

Conclusions:

• SBCE is crucial for evaluating suspected small bowel bleeding, especially in patients on antithrombotic therapy.
• Performing SBCE during inpatient hospitalization enhances diagnostic capabilities for this patient group.