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Overt- hematemesis, coffee ground emesis, hematochezia, melena. Occult- No visible blood. Initial presentation of FOBT positive, IDA. One or both present. Obscure-Occult – Recurrent or persistent IDA, FOBT positive, with negative endoscopies.Obscure-Overt – subset. |~|/files/powerpoints_images/node396661/Slide2.JPG|~|563|~|422|~|0
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Overt- hematemesis, coffee ground emesis, hematochezia, melena. Occu... |
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In 5 studies evaluating the source of occult bleeding, no source was found in 29 – 52 % of patients after upper endoscopy and colonoscopy. Common upper source lesions found were gastritis, esophagitis, and duodenal ulcers. Colorectal lesions were cancer, polyps and AVM’s. Synchronous lesions were found from 1- 17%. In the Rockey and Cello paper, the anemia resolved in 83% of the patients in which no source was found with no recurrence after 20 months of f/u.The cause of bleeding in all GI bleeding cases is found in about 80% - 90% of cases. Therefore, 10% - 20% of all GI bleeding patient’s do not have an identified source of bleeding. Of this group only about 5% of patient’s will have recurrent bleeding without an identified source.|~|/files/powerpoints_images/node396661/Slide4.JPG|~|563|~|422|~|0
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In 5 studies evaluating the source of occult bleeding, no source was ... |
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When you look at all obscure bleeding- occult and obscure.The cause of bleeding in all GI bleeding cases is found in about 80% - 90% of cases. Therefore, 10% - 20% of all GI bleeding patient’s do not have an identified source of bleeding. Of this group only about 5% of patient’s will have recurrent bleeding without an identified source.|~|/files/powerpoints_images/node396661/Slide5.JPG|~|563|~|422|~|0
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When you look at all obscure bleeding- occult and obscure.The cause o... |
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The cause of bleeding in all GI bleeding cases is found in about 80% - 90% of cases. Therefore, 10% - 20% of all GI bleeding patient’s do not have an identified source of bleeding. Of this group only about 5% of patient’s will have recurrent bleeding without an identified source.|~|/files/powerpoints_images/node396661/Slide6.JPG|~|563|~|422|~|0
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The cause of bleeding in all GI bleeding cases is found in about 80% ... |
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A missed lesion found on a second EGD occurs from 25% to 64% in the literature. Most commonly missed lesions are vascular ectasias, Cameron ulcers, and peptic ulcers. Biopsies of the small bowel to evaluate for Celiac disease has a diagnostic yield of 12%. Missed lesions on second colonoscopy are uncommon with a diagnostic yield of only 6 %.|~|/files/powerpoints_images/node396661/Slide15.JPG|~|563|~|422|~|0
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A missed lesion found on a second EGD occurs from 25% to 64% in the l... |
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Yield for barium studies is low and they can not dx angiodysplasia|~|/files/powerpoints_images/node396661/Slide18.JPG|~|563|~|422|~|0
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Yield for barium studies is low and they can not dx angiodysplasia |
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Recorder is worn on a belt enabling patient to continue with daily activities during the procedure.|~|/files/powerpoints_images/node396661/Slide25.JPG|~|563|~|422|~|0
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Recorder is worn on a belt enabling patient to continue with daily ac... |
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The is a guide for placement of the sensors on the chest and abdomen. There are eight sensors. The sensors are attached to the chest and abdomen. The patient swallows the capsule. The sensors are attached to the data recorder. The data recorder is worn on a belt around the waist. As the capsule travels through the GI tract, it transmits images to the sensors. Which transmit the images to the data recorder. The data recorder stores the images.|~|/files/powerpoints_images/node396661/Slide26.JPG|~|563|~|422|~|0
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The is a guide for placement of the sensors on the chest and abdomen.... |
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So to summarize, capsule endoscopy is a time efficient, patient friendly, and sensitive method to visualize the esophagus and small bowel. It is less invasive and requires no sedation so that patients can return to work or return immediately to their daily routine is. It visualizes the entire length of the small bowel. It offers a less invasive alternative to traditional endoscopy to evaluate the esopahgus and small bowel. |~|/files/powerpoints_images/node396661/Slide45.JPG|~|563|~|422|~|0
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So to summarize, capsule endoscopy is a time efficient, patient frien... |
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The DBE consists of an endoscope|~|/files/powerpoints_images/node396661/Slide49.JPG|~|563|~|422|~|0
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The DBE consists of an endoscope |
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So the future magic pill is probably be a radio-controlled capsule that crawls through the GI tract with the capability of not only visualizing the mucosa and measuring GI pressure, ph and temperature, but also of sampling GI secretions, of dispensing medications along the GI tract and maybe even to treating lesions. |~|/files/powerpoints_images/node396661/Slide60.JPG|~|563|~|422|~|0
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So the future magic pill is probably be a radio-controlled capsule th... |
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