Capsule Endoscopy for HEmorrhage in the ER
Capsule Endoscopy for HEmorrhage in the ER
This is a multi-center randomized controlled trial examining the use of Video Capsule
 Endoscopy (VCE) to discharge low-moderate risk patients with suspected upper gastrointestinal
 bleeds (UGIB) from the Emergency Department (ED.) The investigators will enroll 100 subjects
 at 4 sites who present with signs of hemodynamically stable UGIBs and compare VCE risk
 assessment to an Active Control (AC) group who receive inpatient upper endoscopy (EGD).
Inclusion Criteria:

 -  Individuals aged 18 years or older presenting to the Emergency Department with acute
 overt UGIB, defined as bloody emesis and/or coffee ground vomiting and/or melena
 within the previous 48 hours.

 Exclusion Criteria:

 -  Stable for discharge without further testing (Glasgow Blatchford Score of 0

 -  Upper GI bleed with hemodynamic shock (BP <90mmHg and pulse > 120 beats per minute)

 -  Active hematemesis

 -  High- Risk Upper GI Bleed (Glasgow Blatchford Score greater than or equal to 6)

 -  Known history of gastric cancer

 -  Known history of gastric or esophageal varices

 -  GI surgery within the last 6 months

 -  Dysphagia, swallowing disorder, Zencker' s diverticulum, suspected bowel obstruction
 or perforation.

 -  Gastroparesis, Gastric outlet obstruction, Crohn's disease, past UGI tract surgery

 -  Pregnancy/ lactation

 -  Altered mental status (e.g., hepatic encephalopathy) that limits the ability to
 swallow a capsule

 -  Expected to have Magnetic Resonance Imaging examination within 7 days

 -  On medications that may coat the upper GI tract such as antacids or sucralfate or
 Maalox.

 -  Patient either refuses or is unable to get traditional EGD.

 -  Patient does not have reliable contact information - no phone, no permanent address.

 -  Patient refuses

 -  Unable to provide written consent

 -  Prisoner

 -  Non-English Speaker

 -  Suspected small bowel or lower GI Bleeding

 -  Unable to follow up with confirmatory EGD.