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This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Feasibility of capsule endoscopy in elderly patients with obscure gastrointestinal bleeding. An up-to-date report

G Orlando4, IM Luppino1, MA Lerose4, R Gervasi4, B Amato2, G Silecchia3 and A Puzziello4*

Author Affiliations

1 Gastroenterology and Endoscopy Unit, T. Campanella Oncological Foundation, Catanzaro, Italy

2 General Surgery Unit, Dept of General Surgery, Geriatric and Endoscopy, University Federico II, Naples, Italy

3 General Surgery Unit, Dept of Medical and Surgical Biotechnology and Sciences, University la Sapienza, Roma, Italy

4 Endocrinosurgery Unit, Dept of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy

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BMC Surgery 2012, 12(Suppl 1):S30  doi:10.1186/1471-2482-12-S1-S30

Published: 15 November 2012

Abstract

Background

Anemia 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.

Methods

We 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.

Results

We 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.

Conclusions

Iron 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.