Q) Least useful investigation in a patient with recurrent Lower GI bleed, multiple upper and lower GI endoscopies negative?
a) BMFT
b) Double balloon enteroscopy
c) Capsule endoscopy
d) Push endoscopy
Answer: a) BMFT
Investigations in lower GI bleed should be specific and less time consuming.
Small bowel enteroclysis (BMFT), which uses barium and contrast infusion, has a very low yield and is poorly tolerated, hence rarely used.
Capsule endoscopy is excellent for stable patients, with success rates up to 90% in detecting small bowel pathology.
Push enteroscopy can reach 50–70 cm beyond the ligament of Treitz and permits both diagnosis and therapy; success ~40%.
Double-balloon enteroscopy provides complete small bowel evaluation and allows biopsy and therapy, with yield 77–85%.
Therefore, BMFT is the least useful investigation.