Capsule Endoscopy Versus Conservative Therapy for Obscure Gastrointestinal Bleeding

Inclusion Criteria: * Adult men and post-menopausal women with iron deficiency anemia and pre-menopausal women with iron deficiency anemia and a negative gynecologic workup or adults with overt GI bleeding as defined by melena or hematochezia with a ≥2 gram drop in hemoglobin after stabilization (Iron deficiency is defined as hemoglobin \<13.7 g/dL in men and \<12 g/dL in women with serum ferritin level \<50 ng/mL). Also, patients with an otherwise unexplained drop in hemoglobin of ≥ 2 g/dL in the setting of hemoccult positive stool * Negative EGD and colonoscopy for source of GI bleeding within six months of enrollment into the study. Exclusion Criteria: * Ongoing overt gastrointestinal bleeding requiring ≥4 units of packed RBC's on any given day in the setting of overt bleeding, blood transfusions on separate days (separated by ≥12 hours), or ≥6 units of packed RBC's over the previous 7-day period prior to presentation, in the setting of overt bleeding. * Myocardial infarct, acute neurologic event, sepsis, or respiratory failure within the previous 1 week * History of small bowel obstruction * Pregnant women * Prisoners * Age less than 18 * Known GI or hematologic malignancy * Achalasia * Contraindications to capsule endoscopy (inability to take prep), or felt unsafe to undergo capsule as per study investigators * Esophageal stricture that precludes even endoscopic capsule placement * History of upper GI or small bowel surgery * Inability to take oral iron. * Active IV i…