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Tion materials and methods results discussion references introduction obscure gastrointestinal bleeding (ogib) is generally characterized as persistent or recurrent gib, which cannot be identified by conventional gastrointestinal endoscopy and/or conventional radiological examinations of the small intestine (1). viagra overnight Pathological changes in the small intestine account for 2-10% of all causes for ogib; however, they are poorly identified by conventional approaches. As an emerging means of examination for ogib, capsule endoscopy (ce) examination is becoming commonly used in practice and widely accepted by patients due to its noninvasive technique and direct vision of the intestine (2,3). viagra online cheap The diagnostic rate of ogib with ce examination varies from 38% to 93% (3-8), and the major pathological changes identified include vascular malformations, intestinal tumors, crohn's disease, and non-steroidal anti-inflammatory (nsaid)-related enteropathy, amongst others, in previously reported studies (38). candian vigra order cheap A meta-analysis has shown that ce is superior to push enteroscopy and small intestine barium radiography for the diagnosis of clinically significant small intestinal pathology in patients with ogib. can i buy viagra online In the study populations, the incremental yield of ce over push enteroscopy and small bowel barium radiography for clinically significant findings is more than 30% with a number needed to test of 3, which was primarily due to the ability of ce to visualize additional vascular and inflammatory lesions directly (9). In our previous study, we have also proven ce to be a safe, comfortable and effective procedure, with a high rate of accuracy for the diagnosis of ogib. buy viagra canada The rates of visualization of the entire small intestine and of clinically positive findings were 81. viagra 20 mg walmart 88% and 53. 72% of cases, respectively (10). In addition, we compared the clinical efficacy of ce examination and multiple-detector computed tomography (mdct) diagnostic imaging, which is another noninvasive diagnostic tool for small intestinal disorders, in the identification of ogib. generic viagara canada We found that the positive rate for ce (57. 72%) was significantly higher than that of mdct (30. viagra canada best price 08%). In addition, the detection rate due to the combination of ce and mdct was significantly higher than that of mdct alone. However, this was not significantly higher than that of ce alone, which suggested that the contribution of ce is critical in the diagnosis of ogib (11). candian vigra order cheap However, limited evidence exists as to the diagnostic value of ogib in patients of. can i buy viagra online