– Investigators use PillCam SB to determine link between Proton Pump Inhibitor therapy use and Iron Deficiency Anemia – – Additional study reports PillCam SB better than EGD or colonoscopy at identifying bleeding source in patients with diverticular disease –
"Is There Still a Need to Perform Video Capsule Endoscopy for GI Bleeding When Colonoscopy Has Already Found Diverticulosis?," poster P1728 : presented by Neal Patel M.D., and colleagues, Georgia Regents University, Augusta, GA, and Jessica McGann, M.D., Medical College of Georgia, Augusta, GA. The investigators sought to determine the diagnostic yield of PillCam SB for the localization of a GI bleed when colonic diverticular disease is present, but not bleeding at the time of an endoscopy. The review of medical records of patients with diverticular disease showed that the diagnostic yield for PillCam SB for patients with diverticular disease and a GI bleed that was not identified on EGD or with colonoscopy was 44%. The yield was even higher in patients 65 years or older (50%) than patients younger than 65 (33%). The study suggests that PillCam SB should be used to identify the source of a GI bleed not identified during EGD or colonoscopy in patients with diverticular disease.
" Diagnostic Yield of Capsule Enteroscopy (CE) for GI Bleeding: Is Balloon Enteroscopy (DBE) Yield Maximized by a Top-down or Bottoms-up Approach?," poster P1368: presented by Wiley Truss M.D., and colleagues, University of Alabama, Birmingham, AL. The investigators examined the most common locations for small bowel mucosal abnormalities detected by Capsule Endoscopy (CE) in order to better direct the route of deep enteroscopic procedures. In the 220 capsule studies that were performed for obscure GI bleeds, 85% revealed some type of mucosal abnormality, but only 58% showed a clinically significant finding, defined as any mucosal abnormality that could explain the patient's clinical presentation. Results showed that the PillCam SB procedure led to further diagnostic and therapeutic intervention in 39% of cases. The diagnostic yield for PillCam SB in obscure GI bleeding is highest in the proximal small bowel and therefore amenable to anterograde deep enteroscopy. PillCam SB offers a valuable initial diagnostic tool for guiding the route of approach for further therapeutic intervention.
"Using Capsule Enteroscopy Imaging to Analyze the Effects of Proton Pump Inhibitor Therapy and Its Association to Iron Deficiency Anemia," poster P524 : presented by Rezwan Ahmed M.D., and colleagues, Marshall University, Barboursville, WV, and John Davitt, M.D., Boston University, Boston, MA. The investigators evaluated PillCam SB as an imaging modality to analyze the link between Proton Pump Inhibitor (PPI) therapy use and Iron Deficiency Anemia (IDA). A retrospective chart review of 200 patients found that the majority of patients had a capsule endoscopy procedure after having a small bowel follow through, upper endoscopy, and colonoscopy. Previous studies have shown that combining camera-based scoping techniques and x-rays with radiopaque contrast serves as a model to detect a large number of pathologies within the gastrointestinal system. The authors concluded that based on present findings and prior negative studies, there is an important association between PPI use and IDA. Healthcare providers should become aware of this link and be judicious with prescribing PPIs to their patients.
An additional study, "Characterizing the Learning Curve and Accuracy of Wireless Capsule Endoscopy Interpretation Amongst Digestive Healthcare Practitioners," poster P1713: presented by researchers at University of Pennsylvania Perelman School of Medicine, PA, Johns Hopkins Hospital, MD, and University of Texas Medical School, TX, evaluated the accuracy and learning curve of wireless capsule endoscopy (WCE) trainees without prior WCE experience including GI fellows, CRNP fellows and senior GI nurses. Results suggest that a minimum of 25 WCE studies, with each study read in its entirety, appear to be sufficient for trainees enrolled in a GI fellowship program where they are actively performing endoscopy. Physician extenders and nurses appear to require interpretation of more than 25 WCE studies before adequate proficiency is achieved.About PillCam ® SB The PillCam SB capsule is a minimally invasive procedure to visualize and monitor small bowel abnormalities associated with Crohn's disease, iron deficiency anemia (IDA) and obscure GI bleeding (OGIB). The PillCam measures 11 mm x 26 mm and weighs less than four grams. Now in its third generation, PillCam SB 3 contains an imaging device and light source and transmits images at a rate between two and six images per second. Initially cleared by the U.S. Food and Drug Administration in 2001, PillCam SB is an accurate, patient-friendly tool used in patients two years and older by physicians to visualize the small bowel. PillCam SB 3 builds on Given Imaging's unique expertise and collaborative efforts as an industry leader that includes more than 2 million uses of PillCam capsules in patients worldwide and more than 1,900 clinical studies.