Sihag S, O’Hara F, McNamara D. Toward an expanded role for video capsule endoscopy in patients with gastrointestinal bleeding: A review of the literature. World J Gastrointest Endosc 2025; 17(11): 108788 [PMID: 41256306 DOI: 10.4253/wjge.v17.i11.108788]
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Sandeep Sihag, Lecturer, MRCP, Department of Gastroenterology, Tallaght University Hospital, Belgard Road, Tallaght, Dublin D24 NR0A, Ireland. sihags@tcd.ie
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Gastroenterology & Hepatology
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 20, 2025
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World Journal of Gastrointestinal Endoscopy
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1948-5190
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Sihag S, O’Hara F, McNamara D. Toward an expanded role for video capsule endoscopy in patients with gastrointestinal bleeding: A review of the literature. World J Gastrointest Endosc 2025; 17(11): 108788 [PMID: 41256306 DOI: 10.4253/wjge.v17.i11.108788]
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 108788 Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.108788
Toward an expanded role for video capsule endoscopy in patients with gastrointestinal bleeding: A review of the literature
Sandeep Sihag, Fintan O’Hara, Deirdre McNamara
Sandeep Sihag, Fintan O’Hara, Deirdre McNamara, Department of Gastroenterology, Tallaght University Hospital, Dublin D24 NR0A, Ireland
Deirdre McNamara, Trinity Academic Gastroenterology Group Research Centre, Trinity College Dublin, Dublin D02 PN40, Ireland
Author contributions: Sihag S was responsible for data curation, literature search and drafting of the manuscript; Sihag S and O’Hara F contributed in literature search and drafting of manuscript; Sihag S and McNamara D contributed to conceptualization; McNamara D contributed to supervision and critical revision of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sandeep Sihag, Lecturer, MRCP, Department of Gastroenterology, Tallaght University Hospital, Belgard Road, Tallaght, Dublin D24 NR0A, Ireland. sihags@tcd.ie
Received: April 27, 2025 Revised: June 10, 2025 Accepted: September 23, 2025 Published online: November 16, 2025 Processing time: 202 Days and 14.6 Hours
Abstract
The role of small bowel capsule endoscopy (CE) in suspected small bowel bleeding is well established and current European and other international guidelines position it as the first line test after negative bidirectional endoscopies. In suspected mid-lower gastrointestinal bleeding (MLGIB) the diagnostic yield of colonoscopy is poor and may cause a delay in detecting small bowel disease. A crucial aspect of small bowel capsule endoscope performance is the timing of the procedure, the interval between the bleeding episode and capsule ingestion is inversely related to the diagnostic yield as confirmed by a recent meta-analysis. Currently the ongoing advances achieved by video CE in particular to evaluate both small bowel and colon in a single test using double headed capsules, raises questions regarding the position of pan intestinal capsule in the current algorithm to investigate patients presenting with suspected MLGIB ahead of colonoscopy. Early evidence suggests pan intestinal capsule could fit well as a diagnostic “filter” test in this cohort of patients, thereby reserving invasive conventional colonoscopy or device assisted enteroscopy as therapeutics options only. The recent development of magnetically controlled CE and a blood sensing capsule push the boundaries of CE even further in patients presenting with suspected gastrointestinal bleeding. This review will discuss the current available evidence and future directions of CE in suspected MLGIB.
Core Tip: This review comprehensively discusses the emerging role of pan intestinal capsule in patients with gastrointestinal (GI) bleeding. With recent technical advancements capsule endoscopy have enabled to potentially assess the entire GI tract mucosa in a single, minimally invasive procedure. This will contribute to optimize the diagnostic work up of GI bleeding patients by reducing the need for multiple investigations and time to diagnosis.
