Abstract
BackgroundAnemia is the most common hematologic abnormality in older populations. Furthermore, iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. In view of a wide use of capsule endoscopy as a diagnostic procedure for occult gastrointestinal bleeding and of the growth of aging population, we performed a literature review about the feasibility of capsule endoscopy in the elderly.MethodsWe conducted a literature search in the PubMed database in July 2012, and all English-language publications on capsule endoscopy in elderly patients since 2005 were retrieved. The potential original articles mainly focused on obscure gastrointestinal bleeding were all identified and full texts were obtained and reviewed for further hand data retrieving.ResultsWe retrieved only six papers based on different primary end-points. Four were retrospective non randomized studies and two were prospective non randomized studies. In the end 65, 70, 80 and 85 years were used as an age cut-off. All studies evaluate the diagnostic yield of capsule endoscopy in iron deficiency anemia. Only three studies assess the feasibility of capsule examination of the elderly.ConclusionsIron deficiency anemia in the elderly with or without obscure gastrointestinal bleeding is the major indication for capsule endoscopy after a negative esophago-gastro-duodenoscopy and colonoscopy. It is safe and effective to identify a small bowel pathology without a great discomfort for the elderly. Inability to swallow the capsule, battery failure before capsule reaches the cecum, and capsule retention are some of the important problems associated with capsule endoscopy in elderly as well as in younger patients.
Highlights
Anemia is the most common hematologic abnormality in older populations
In our study, we found no differences between the aged group and younger group with regard to the probability of completing the small bowel study and small bowel transit time
Since the first brief communication published in Nature in 2000 [6] introducing capsule endoscopy, CE has been so widely used in clinical practice that, it is a useful tool for evaluating small bowel disease, some authors demonstrated the utility and safety in patients who have undergone small-bowel resection for benign or malignant disease [3]
Summary
Anemia is the most common hematologic abnormality in older populations. iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. Capsule endoscopy (CE) has developed an important role in the investigation of patients with obscure gastrointestinal bleeding (OGB) when upper endoscopy, push enteroscopy, colonoscopy, and barium contrast radiography of the small bowel are negative. In view of a wide use of CE as a diagnostic procedure for OGB and of the growth of an aging population we performed a literature review on the utility and safety of CE in the elderly with obscure gastrointestinal bleeding. Iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. In view of a wide use of capsule endoscopy as a diagnostic procedure for occult gastrointestinal bleeding and of the growth of aging population, we performed a literature review about the feasibility of capsule endoscopy in the elderly
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