Decreasing hospital admissions with capsule endoscopy

As a leading cause of hospital admissions through the emergency department, upper gastrointestinal bleeding (UGIB) could be avoided with the use of capsule endoscopy.

Symptoms of UGIB are often shown without an actual bleed or high risk situation, prompting patients to rush to the hospital only to find out its nothing too serious. A hospital admission could be avoided right in the emergency room with the use of a capsule endoscopy. A study in the journal of the American Society for Gastrointestinal Endoscopy aimed to show the process as safe and effective in reducing admissions.

In a randomized controlled trail, 71 participants who had presented with symptoms of UGIB were split in groups receiving standard treatment or a capsule endoscopy. Some 37 participants received the capsule endoscopy and 34 received standard care. All standard care participants were admitted to the hospital where only seven capsule endoscopy participants were admitted after results showed a need for admission. Hospital admission were significantly reduced when capsule endoscopy’s, rather than standard hospital assessment, was used and also showed no difference in the effect of recurrent bleeding and 30-day mortality.

“This is the first randomized study to show that capsule endoscopy (CE) can be used safely to identify which patients presenting with symptoms suggestive of UGIB are high-risk individuals requiring hospital admission,” concluded Joseph J.Y. Sung, MD, PhD, first author on the study. “It is safe in the sense that swallowing the capsule endoscope in these patients did not create any problems or adverse events. With the use of CE, this study showed that triaging patients can be done effectively because hospital admission has been reduced by almost 80 percent. This is a large reduction in hospital work, which carries a significant impact on the financial and workload burden of the hospital system. This result, however, is related to the emergency setting. Gastroscopy and colonoscopy are still needed during follow-up to discover the source of bleeding."