Abstract
Introduction Despite the widespread use of small-bowel capsule endoscopy (CE), there is still
limited data on its utility and effectiveness for the diagnosis and management of
patients with iron-deficiency anemia (IDA).
Aim To assess the diagnostic yield of CE and the factors predicting positive findings
in patients with IDA.
Methods Patients with unexplained IDA and negative upper and lower endoscopy were included.
A positive diagnostic yield was considered when CE diagnosed one or more lesions that
could explain the IDA. Sex, age, NSAID consumption, blood transfusion requirement,
and ferritin and hemoglobin levels were recorded.
Results In total, 120 CE were included (mean age 58.5 years; F/M 82:38). Mean hemoglobin
levels were 9 g/dL and mean ferritin levels were 15.7 ng/mL. Positive findings were
present in 50 % of patients. The most frequent was angiodysplasia (45 %). Despite
several baseline variables being significantly associated with positive findings,
using a logistic regression model, it was verified that male sex (OR 3.93; 95 %CI
1.57 – 9.86), age (OR 1.03; 95 %CI 1.00 – 1.06), and hemoglobin levels (OR 0.73; 95 %CI
0.57 – 0.94) were the variables having an independent effect on the probability of
obtaining positive findings. Age older than 50 years (OR 14.05; 95 %CI 1.69 – 116.23)
and male sex (OR 3.63; 95 %CI 1.29 – 10.17) were the variables which increased the
risk of diagnosing angiodysplasia.
Conclusions CE is a useful technique in patients with IDA. To improve its yield, it is necessary
to select patients carefully. Male sex, older age, and low hemoglobin levels were
associated with a risk of positive finding in this group of patients. The risk of
diagnosing angiodysplasia increased with male sex and older age.
