Iron Deficiency Anemia Clinical Trial
Official title:
Diagnosis of Upper Gastrointestinal Pathology in Patients With Recurrent/Refractory Iron Deficiency Anaemia: Magnetically Steerable Gastric Capsule Endoscopy Versus Conventional Gastroscopy.
This is a pilot prospective single blind controlled trial comparing magnetically steerable gastric capsule endoscopy to conventional oesophagogastroduodenoscopy in diagnosing upper gastrointestinal pathology in patients with recurrent/refractory iron-deficient anaemia.
Gastroscopy (OGD) is a useful test for investigating a variety of suspected upper GI
disorders. But it is uncomfortable for patients and incurs the risk of intubation and
sedation, plus a large proportion of procedures reveal insignificant or no pathology. Capsule
endoscopy (CE) is the investigation of choice for diseases of the small bowel. It is safe,
noninvasive and well tolerated.
The use of CE is traditionally restricted to the small bowel, although newer capsules to
image the oesophagus and colon are currently in use. Previous capsules have failed to
adequately image the stomach due to its large volume and rugal folds. Recently a magnetic
capsule and handheld magnet has been developed (Microcam Navi, Intromedic Ltd, Seoul, Korea)
to enable an element of manoeuvrability of the capsule. This is unnecessary in the small
bowel where the capsule is propelled along its' tubular structure by peristalsis, but in the
capacious stomach this may allow the capsule to be steered to examine all areas of the
stomach.
The investigators have already conducted two feasibility studies in porcine models with
promising results and a trial is currently underway using this equipment to steer the small
bowel capsule through the stomach into the duodenum. The next logical step is to compare this
technique to the conventional standard of upper GI investigation; OGD. Patients with
recurrent or refractory iron deficiency anaemia require a combination of gastroscopy and
small bowel capsule endoscopy as part of their diagnostic investigations. The investigators
wish to undertake a pilot prospective single blind controlled trial comparing magnetically
steerable gastric capsule examination to conventional OGD in diagnosing upper
gastrointestinal pathology in patients with recurrent/refractory iron deficiency anaemia.
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