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Capsule endoscopy has been shown to identify lesions in some patients with obscure gastrointestinal bleeding (GIB). To assess whether this diagnostic procedure actually improves clinical outcomes, investigators randomized 136 patients with obscure GIB (54 with overt bleeding and 82 with occult bleeding) to undergo either capsule endoscopy or small-bowel radiography. All patients had previously documented negative findings on colonoscopy, upper endoscopy, and push enteroscopy. Reevaluations and hemoglobin tests were conducted systematically for 1 year.
The diagnostic yield was significantly greater with capsule endoscopy than with radiography (30% vs. 7%). This 23% absolute difference did not, however, correspond to significant differences in…