Abstract: Objective To investigate the current diagnosis and treatment status of small-bowel diseases and clinical application of small-bowel endoscopy in Beijing tertiary-level hospitals. Methods The internet-based questionnaire was used to investigate the application of capsule endoscopy (CE) and balloon assisted enteroscopy (BAE), proficiency in current guidelines and continuing medical education (CME) activities, as well as management strategy for obscure gastrointestinal bleeding (OGIB). Results Twenty nine tertiary-level hospitals in Beijing were investigated. 24 (82.8%) hospitals equipped with CE and 12 (41.4%) with BAE. The median application time was 5-6 years. Median cases received CE per hospital one year was 50-100 with a failure rate of 1%-3%. While median cases received BAE per hospital one year was less than 50 with a failure rate of 3%-5%. The incidence of severe complications of CE and BAE was less than 1% and overall diagnosis rate was 50%-60%. The positive rate of CE of each hospital was positive correlation with received CE cases per year(r=0.542,P=0.005). Only half of the respondents mastered the guideline of CE and 20.7% never attended CME program. Respondents engaged in small-bowel endoscopy working had different diagnosis strategies for first diagnosed negative OGIB patients with those not engaged in small-bowel endoscopy working(χ²=3.898,P=0.048). Conclusion More hospitals are equipped with CE than BAE in Beijing tertiary-level hospitals. Both CE and BAE are safe for clinic use with similar diagnostic yield of 50%-60%. Physicians have insufficient knowledge of guideline and standard process of CE and more continued medical education (CME) should be recommended in the future. The procedure of diagnosis and treatment for OGIB needs to be further standardized.

Key words: small-bowel disorders, diagnosis and treatment, small-bowel endoscopy