Reply to Allo et al.

10.1055/a-2742-4209

We appreciate the comment of Allo et al. and their interest in our article, in which we evaluated a photometric capsule examination (PCE) to stratify patients with suspected nonvariceal upper gastrointestinal bleeding (NVUGIB) into emergency versus elective endoscopy [1].

As the current study was designed as a feasibility study for the use of PCE for patient stratification in an emergency setting, inpatient monitoring of patients with negative PCE until elective endoscopy (after 48–96 hours) was thought to be necessary for safety reasons.

Although a delay in endoscopy only seems reasonable on weekends due to limited bed capacity, PCE can help avoid emergency transfers to larger centers, especially in hospitals where emergency endoscopy is not available on weekends. We fully agree that assessing the savings in endoscopy on-call services to offset the additional financial costs of PCE and inpatient stays is an interesting topic. However, this was not the aim of the study and therefore cannot be conclusively assessed.

We fully agree with the authors that PCE has great potential for risk assessment in patients with suspected NVUGIB, particularly with regard to safe outpatient treatment, which is currently only recommended for the few patients with a Glasgow–Blatchford score ≤1 [2].

Future studies should address this issue, but a risk-adapted approach (fit patients with low comorbidity and without anticoagulation) should be adopted initially. Based on our study data, outpatient endoscopy within 48–96 hours appears to be safe.

In summary, we agree with the authors that PCE has great potential for risk assessment of NVUGIB, including outpatient treatment options. Further studies will hopefully provide valid results regarding this issue.

Publication History

Article published online:
22 January 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 2025;
• 2 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