Does Capsule Endoscopy Improve Outcomes in Obscure Gastrointestinal Bleeding?

Capsule endoscopy is now used widely to evaluate patients with obscure gastrointestinal (GI) bleeding, but does it improve clinical outcomes? To address this question, Los Angeles researchers enrolled 136 patients with GI bleeding, the source of which remained unknown after patients underwent colonoscopy, upper endoscopy, and push enteroscopy (passage of a long enteroscope beyond the ligament of Treitz). Patients were randomized to receive either capsule endoscopy or dedicated small bowel radiography as the next step. After these tests, clinicians were free to initiate any additional diagnostic and therapeutic interventions. Intended follow-up was 1 year.

Capsule endoscopy was associated with a higher diagnostic yield than was radiography (3…