SMALL BOWEL CAPSULE ENDOSCOPY IN THE WEST OF IRELAND: A CLOSER LOOK AT THE FIRST YEAR

Aims The European Society of Gastrointestinal Endoscopy (ESGE) recommends SBCE as the first line investigation in patients with obscure GI bleeding. SBCE is also indicated to assist in the diagnosis of small bowel Crohn’s disease. The aim of this study was to look at SBCE in the West of Ireland.

Methods This is a retrospective review of all SBCE performed in University College Hospital Galway since the introduction of the service in March 2019. All patients undergoing SBCE during this time were included. Data were collected from Pilcam studies. Demographics, indication and outcome were recorded. Quality of bowel preparation, transit time and need for patency testing were also analysed. The use of anticoagulation/antiplatelet therapy was recorded.

Results In total, 61 patients underwent SBCE during the study period. Pathology was seen in 44 (72%) of the cases. 41 (67%) were referred for investigation of obscure GI bleeding or iron deficiency anaemia. 16 of these patients (39%) were taking anticoagulation/antiplatelet therapy. 26 (59%) were found to have angiodysplasia/angioectasia. Within this group, 50% of patients were taking anticoagulation/antiplatelet therapy compared to 12% of those in which no pathology was seen. The average age of those found to have angiodysplasia was 66.7 compared to 41 in those with other/no pathology. 16 patients were referred for diagnosis or assessment of small bowel Crohn’s disease. 10 (62.5%) had findings consistent with the diagnosis.

Conclusions The introduction of SBCE in our centre has proven to be a useful addition for assisting in investigation of obscure GI bleeding and other small bowel pathology with positive findings detected in almost three quarters of the patients. It can be performed in an outpatient setting and has a very high completion rate. The use of anticoagulant/antiplatelet therapy may increase the risk of obscure GI bleeding/IDA due to angiodysplasia.