ArticleCureus2025
The Diagnostic Yield of Video Capsule Endoscopy for Uncomplicated Asymptomatic Iron Deficiency Anemia With Negative Bidirectional Endoscopy in a Large Military Gastroenterology Program.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Distinct clinical course and poor outcomes of small bowel bleeding in acute hematochezia: a nationwide multicenter study.Scientific reports · 2026Article
- Article
- Toward an expanded role for video capsule endoscopy in patients with gastrointestinal bleeding: A review of the literature.World journal of gastrointestinal endoscopy · 2025Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIron-deficiency anemia (IDA) often results from gastrointestinal (GI) bleeding. Video capsule endoscopy (VCE) is increasingly used to investigate suspected small bowel bleeding, particularly when bidirectional endoscopy is nondiagnostic. However, the diagnostic yield of VCE in asymptomatic patients with IDA and negative bidirectional endoscopy is not well-established, leading to variability in clinical guidelines.
methodsWe conducted a retrospective review of patients at Brooke Army Medical Center who underwent VCE from January 2019 to April 2023 following negative bidirectional endoscopy for IDA, defined as ferritin <45 ng/mL. We analyzed demographic data, VCE findings, and outcomes, including need for further intervention, persistence of IDA, and hospitalizations. We also assessed the impact of referral delays on outcomes.
resultsOut of 238 patients, 75 met the inclusion criteria. VCE revealed abnormal findings in 36% of cases, with 8% having actionable findings necessitating repeat endoscopy. The most common abnormality was small bowel angiodysplasias. No small bowel malignancies were detected. Patients aged over 65 had a higher rate of abnormal findings and actionable lesions. Delays in subspecialty evaluation (>180 days) did not significantly affect patient outcomes.
conclusionIn asymptomatic IDA patients with negative bidirectional endoscopy, VCE demonstrates a 36% diagnostic yield, primarily identifying small bowel angiodysplasias, with limited impact on detecting malignancies. This study highlights the importance of individualizing VCE use to each patient, and suggests that delays in referral do not adversely affect outcomes. Further prospective studies are needed to refine diagnostic guidelines and enhance cost-effectiveness.
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