Video capsule endoscopy, double-balloon enteroscopy effective for non-small bowel bleeding
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Key takeaways:
- The diagnostic yields of video capsule endoscopy and double-balloon enteroscopy for indications without bleeding were 53% and 61.7%.
- No difference in diagnostic yields in bleeding vs. non-bleeding indications.
Video capsule endoscopy and double-balloon enteroscopy were safe and effective in the management of patients with indications other than suspected small bowel bleeding, including celiac disease and Crohn’s disease, researchers reported.
“In the last two decades, video capsule endoscopy and device-assisted enteroscopy, most commonly double-balloon enteroscopy, have emerged as reference standards for the diagnosis and endoscopic treatment of small bowel diseases,” Matilde Topa, of the department of pathophysiology and transplantation at the University of Milan, and colleagues wrote in Therapeutic Advances in Gastroenterology. “Their main indication is suspected small bowel bleeding, but in recent years indications other than small bowel bleeding have emerged and are gaining importance.”
With data lacking on the role of these procedures outside of suspected small bowel bleeding, Topa and colleagues conducted a retrospective cohort study to evaluate the clinical impact of video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) in patients with other indications, whom they compared with a control group with suspected bleeding.
More than 2,200 procedures were performed, including 1,418 VCEs on 1,200 patients and 794 DBEs on 592 patients. The median age at enteroscopy was 67 years and 46.6% were men. Researchers reported that 43% and 49% of procedures, respectively, were for indications other than suspected bleeding, mainly celiac disease and Crohn’s disease. Patients undergoing enteroscopy for other indications were significantly younger compared with the control group.
According to study results, the overall diagnostic yields were 53% for VCE and 61.7% for DBE. There were no statistical differences in the diagnostic yields of VCE (57.7% vs. 53%) or DBE (68.8% vs. 61.7%) in patients with suspected bleeding vs. those without.
Further, there were similar reports of “poor agreement” between the two procedures in both patient populations, as well as comparable safety.
“These findings show for the first time that VCE is a valuable and effective tool for the management of patients with suspected or known complicated celiac disease, CD, suspected enteric neoplasm or persistent digestive symptoms, and that its role is comparable with its existing role in suspected bleeding of the small intestine,” Topa and colleagues concluded.
They continued, “In the same way, we also showed that DBE is useful in the clinical management of enteropathies without suspected bleeding because of its high diagnostic yield and because therapeutic procedures may be performed without resorting to surgery.”
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