Reply to Luo

10.1055/a-2793-0676

We thank Dr Luo for the critical comments on our recent article evaluating a photometric capsule examination (PCE) to stratify patients with suspected nonvariceal upper gastrointestinal bleeding (NVUGIB) into emergency versus elective endoscopy [1].

We fully agree with the author that clinical scoring systems are essential for the assessment and management of upper gastrointestinal bleeding, particularly for identifying high-risk patients (Glasgow–Blatchford bleeding score [GBS] ≥12) [2] [3]. However, as the current European Society of Gastrointestinal Endoscopy guideline recommends early endoscopy for all patients with GBS >1, a large, clinically heterogeneous group (GBS 1–11) falls within this recommendation [4].

Hence, our study tested whether PCE is a useful method for further stratifying these patients with intermediate risk in whom endoscopy can potentially be delayed (48–96 hours). As our study was designed as a feasibility study, we agree with Dr Luo that the number of cases and the end points of our study were not designed to determine long-term outcomes (recurrent bleeding and mortality). As mentioned in our discussion, we agree that randomized multicenter studies are necessary to investigate a possible advantage of PCE in relation to these long-term results.

Publication History

Article published online:
20 March 2026

• References

• 1 Brand M, Vogt G, Hann A. et al. Pilot study on using a photometric capsule to stratify patients with suspected nonvariceal upper gastrointestinal bleeding into emergency versus elective endoscopy. Endoscopy 2026; 58: 6-13
• 2 Lau JY, Yu Y, Tang RSY. et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med 2020; 382: 1299-1308
• 3 Stanley AJ, Laine L, Dalton HR. et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ 2017; 356: i6432
• 4 Gralnek IM, Stanley AJ, Morris AJ. et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – update 2021. Endoscopy 2021; 53: 300-332