Can capsule endoscopy be done in a polycythemia vera?

Question

Hello doctor,

My uncle is suffering from bleeding through stool and has undergone a colonoscopy and endoscopy. But the bleeding location has not been detected. We have been asked to do a capsule endoscopy. The patient has polycythemia vera.

Should we go for CT abdomen with CT angiography first for diagnosis?
Can capsule endoscopy be done in a polycythemia vera?

Kindly assist.

Answer 1

Hello,

Welcome to icliniq.com.

I have read through your query in detail.

Bleeding through the stool is a serious concern and needs thorough evaluation and timely management.

The upper and lower GI endoscopy reports do not show any active bleeding in the visualized areas (attachment removed to protect patient identity).

Since the patient has Polycythemia vera, it is also important to assess for possible vascular abnormalities or thrombosis, as these can sometimes affect blood flow within the abdomen.

Given that no bleeding source was identified on endoscopy, I would recommend a contrast-enhanced CT scan of the abdomen and pelvis with CT angiography. This helps evaluate areas beyond the reach of endoscopy, including the bowel wall and surrounding vessels.

Capsule endoscopy can be considered later, depending on the findings of the CT angiography.

I hope it helps.

Please let me know if I can assist you further.

Thank you.