216 Improved Diagnostic Yield With Early Video Capsule Endoscopy After Diagnosis of Obscure Gastrointestinal Bleeding

Abstract

asymptomatic individuals to quantify the amount of injury and attempt to determine baseline scores. Methods: Healthy volunteers were recruited for this IRB-approved study. Subjects were excluded if they had taken any NSAIDs in the two weeks prior to enrollment . Other exclusion criteria included pregnancy, implanted medical devices, a history of Crohn's disease, a previous small bowel resection, a history of anklyosing spondylitis, and gastrointestinal symptoms of diarrhea, abdominal pain or nausea. CE exams were performed after fasting and the administration of simethicone prior to capsule ingestion. All studies were read at a fixed frame rate of 7fps in a quad view. Mucosal breaks were defined as lesions with white or yellow centers and a red border. Scores were determined according to the Lewis Score. Results: 34 volunteers participated in the study (17/34 male, mean age 27 years [range 18-43]). The capsule reached the colon in 31/34 (91%) of exams. All studies were of good or excellent quality. The mean small bowel transit time was 249 minutes (range 78-404 minutes). 31/34 (91%) volunteers received a Lewis Score of zero. Three CE studies had a Lewis Score of 450 for small mucosal breaks in the first and middle tertiles of the small intestine. This score is consistent with mild mucosal injury. There were no adverse events in any of the participants. Conclusion: These results demonstrate that 9% of healthy individuals who do not use NSAIDs will have mucosal breaks on CE with Lewis Scores that do not surpass 450. The percentage of healthy volunteers with mucosal breaks is consistent with prior studies that included healthy individuals. Parameters and relative weight values used to analyze each tertile of small bowel