Positive findings of small bowel capsule endoscopy in patients on antithrombotic therapy: a prospective observational study

Aims The aim of the study is to evaluate the type of lesions detected by small bowel capsule endoscopy (SBCE) in patients on antithrombotic therapy for suspected small bowel bleeding or iron deficiency anemia.

Methods This is a prospective single-center observational study conducted from March 2023 to July 2024. We enrolled patients with suspected small bowel bleeding or iron deficiency anemia undergoing SBCE after bidirectional negative endoscopy from the emergency department, in hospital stay, and outpatient practice of our hospital. Positive findings at the capsule endoscopy were defined according to the P0-P2 classification reported by Saurin et al (1).

Results Between March 2023 and July 2024 237 patients underwent capsule endoscopy in our institute, 94 patients out of 237 were enrolled in the study. We divided our population into four groups based on type of antithrombotic therapy, 34 (36.2%)patients were on antiplatelet, 19 (20.2%) were on anticoagulant, 8 (8.5%) were on both antiplatelet+anticoagulant, and 33 (35.1%) were without an antithrombotic therapy (control). The mean age was 68.5 year (SD±1.3), 53 (56.4%) were male, the mean Hb value at the admission was 9.2 gr/dl (CI 95% 8.7- 9.7). We did not find a statistically significant difference on type of lesions detected by capsule endoscopy between groups, neither analyzing by Saurin classification. However, a difference statistically significant was found when we considered comorbidities, i.e., patients with diabetes and cirrhosis had a major number of P2 lesions.

Conclusions In our study we demonstrate that in patients ongoing antithrombotic therapy small bowel positive findings have the same frequency independently of the therapy. Between antithrombotic groups there is no difference of potential bleeding lesions, patients with bleeding lesions usually are older, requiring more medications and with comorbities such as diabetes and cirrhosis. The limit of the study is the small sample size that could affect the power of estimations.

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Artikel online veröffentlicht:
27. März 2025