Table of Contents
ISRN Gastroenterology
Volume 2011, Article ID 271047, 3 pages
Research Article

A Retrospective Analysis to Validate the Alarm Signs Used in the CEDAP-Plus Study

Department of Gastroenterology, Shenzhen Nanshan Hospital, Guangdong Medical College, Shenzhen, Guangdong 518052, China

Received 12 April 2011; Accepted 3 May 2011

Academic Editors: D. Beattie and E. Bloemena

Copyright © 2011 Hou-De Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Study Aim. This study aimed to validate the alarm signs used in the 2007 German CEDAP-Plus study for indicating capsule endoscopy in patients who have idiopathic chronic abdominal pain. Patients and Methods. We retrospectively reviewed the cases of all patients who underwent capsule endoscopy at our institution between August 2007 and August 2009 for chronic hitherto undiagnosed abdominal pain, despite previous investigations. The demographic data, indications, findings, and diagnoses were recorded, as were the alarm signs (i.e., 10% loss of weight within 3 months, suspected small intestinal bleed or chronic anemia, and laboratory indications of inflammation). Results. Alarm signs were found in only 4 of the 62 included patients. Capsule endoscopy revealed findings that led to diagnoses of Crohn's disease ( 𝑛 = 4 ), tuberculosis ( 𝑛 = 1 ), gastrointestinal stromal tumors ( 𝑛 = 3 ), and hookworm ( 𝑛 = 1 ); these diagnoses included 100% (4/4) of the patients with alarm signs, but only 8.6% (5/58) of patients without them. However, 55.6% (5/9) of patients with clinically capsule endoscopy findings reported no alarm signs. Conclusions. Although selecting patients based on the alarm signs may increase the yield of capsule endoscopy, the alarm sign criteria appear to have low sensitivity.