Diagnosis of small-bowel pathology using paired capsule endoscopy with two different devices: a randomized study

Background and study aims: Capsule endoscopy is an established technique in the evaluation of obscure gastrointestinal bleeding. The primary aim of the study is to compare the diagnostic yield of the two different capsule endoscopes.

Patients and methods: Patients with signs of mid-gastrointestinal bleeding after negative upper endoscopy and colonoscopy studies were included. Patients were randomized to undergo two capsule endoscopies using different capsule endoscopes (Given Pillcam SB and Olympus EndoCapsule) in random order.

Results: Forty patients (18 women, 22 men) were included in the study. All EndoCapsules reached the colon within the mean recording time of 591 ± 52 minutes, whereas 33 out of 40 PillCam SB reached the colon within the mean recording time of 471 ± 27 minutes. Lesions were detected in 31 patients: with both devices in 24, only by PillCam SB in 2, and, conversely, only by EndoCapsule in 5 (not significant). With regard to lesions with high bleeding potential (P2 lesions), PillCam SB detected them in 22 patients, EndoCapsule in 25 patients (not significant). In all four cases of intestinal P2 lesions that were not detected by the PillCam SB but were detected by the EndoCapsule, the PillCam SB had not reached the cecum.

Conclusion: In this study there was a statistically nonsignificant trend for the EndoCapsule to detect more bleeding sources in patients with suspected small bowel bleeding than did the Pillcam SB, which may have been due to the longer recording times with the currently available EndoCapsule.

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