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Evidence to Improve Care

Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends that small-bowel capsule endoscopy continue to be used as a diagnostic procedure in determining the etiology of obscure gastrointestinal bleeding in patients with negative upper and lower endoscopic evaluations.

  • Given the severity of the risk of capsule retention, the Ontario Health Technology Advisory Committee recommends discussion between patients and physicians with respect to this potential risk.

Read the full OHTAC Recommendation



Gastrointestinal bleeding occurs when the lining of the digestive tract, the series of organs that help the body digest food, becomes damaged. In about 5% of cases, the cause of the bleeding cannot be determined with routine medical tests. This is known as obscure bleeding and it most often happens in the small intestine (small bowel). This organ has many complex folds, which can make it hard to find the location and cause of the problem.


Health Quality Ontario Reviews Capsule Endoscopy for Obscure Gastrointestinal Bleeding

Capsule endoscopy is a procedure sometimes used to diagnose obscure gastrointestinal bleeding. This technology allows doctors to examine the digestive tract by using a pill-sized camera. The patient swallows the camera (it is later excreted in the stool) and the camera transmits pictures as it passes through the digestive tract.


Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Evidence-Based Analysis (PDF)
February 2015

Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Economic Analysis (PDF)
February 2015

Related Resources

Wireless Capsule Endoscopy: An Evidence-Based Analysis (PDF)
May 2003


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: This procedure is currently insured in Ontario.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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