Diagnostic Yield of Wireless Capsule Endoscopy for the Evaluation of Iron Deficiency Anemia in Different Age Groups

Abstract

Purpose: Obscure gastrointestinal bleeding (OGIB) could be the source of iron deficiency anemia in patients with normal EGD and colonoscopy. WCE helps in the detection of small bowel mucosal abnormalities such as erosions, ulcerations, angiodysplasia and celiac disease resulting in OGIB and iron deficiency anemia. Aim: The aim of this study is to identify the source of bleeding (OGIB) in the small bowel resulting in iron deficiency anemia with the help of WCE and also to evaluate its diagnostic yield in different age groups. Methods: In this retrospective study, data is collected from 652 consecutive patients who underwent WCE during the last 5-years (2002–2007). Iron deficiency anemia is defined on the basis of low serum ferritin levels (<15 mg/L) and low transferring saturation (<20%). Results: Total cases: 652 (Males = 311, Females = 341). Diagnostic yield of WCE for iron deficiency anemia in different age groups:Figure1) < 50 yrs = 41% 2) 50–64 yrs = 56% 3) 65–85 yrs = 61% 4) > 85 yrs = 70% Conclusion: 1) Iron deficiency anemia is a frequent indication for WCE especially in the older adults (age > 65). 2) The diagnostic yield of WCE in the evaluation of OGIB resulting in iron deficiency anemia progressively increases as age advances. 3) Small bowel erosions, ulcerations and angiodysplasia are the most frequent findings in patients with iron deficiency anemia. 4) Active bleeding in the small bowel was seen mostly in older adults, resulting in an immediate change of management and outcome.[figure1]Table: Diagnostic yield of WCE for evaluation of iron deficiency anemia in all age groups