Up to 5% of patients with recurrent gastrointestinal (GI) bleeding remain undiagnosed by EGD
and colonoscopy, the presumed source of bleeding in these patients being the small
intestine. These patients fall under the category of "obscure gastrointestinal bleeding,"
and frequently require an extensive diagnostic work-up. For these reasons, most patients who
present with obscure or occult gastrointestinal bleeding typically undergo multiple
endoscopic evaluations, including capsule endoscopy and various radiologic imaging studies,
including enteroclysis, small bowel series, CT scan, angiography, and radionuclide scan.
Recently, many centers (included the Brigham and Women's Hospital) have begun using capsule
endoscopy and CT enterography (CTE) for evaluation of suspected small bowel pathology. This
is an observational study enrolling patients referred to the Brigham and Women's Hospital
for obscure gastrointestinal bleeding designed to compare the diagnostic yield of various
diagnostic modalities, in particular capsule endoscopy and CT enterography in the evaluation
of obscure gastrointestinal bleeding.
- Anemia, hematochezia, melena, Hematemesis, heme positive stool with negative
- Under the age of 18
- Unable to give consent
- IV Contrast Allergy (excluded from CT)
- Renal insufficiency (excluded from CT)
- Unable to swallow (excluded from capsule)
- Small bowel obstruction or stricturing disease (excluded from capsule)