Rifaximin and Misoprostol Combination Therapy for Healing of Small Bowel Ulcers in Aspirin Users

Inclusion Criteria: * Suspected small bowel overt bleeding - melena or hematochezia with or without a source of bleeding from gastroscopy and colonoscopy or suspected small bowel occult blood loss - defined as a significant decrease in hemoglobin (\> 2g/dL), without a source of bleeding from gastroscopy and colonoscopy, confirmed iron deficiency anemia, and absence of other identifiable causes for hemoglobin decrease (e.g. fluid overload, progressive renal failure, malnutrition, or other hematological disorders such as hemolysis or malignancies) * Continuous use of aspirin for the duration of the trial * Age ≥ 18 * Written informed consent obtained Exclusion Criteria: * Increased risk of capsule retention (e.g. gastric outlet obstruction, bypass surgery, Crohn's disease or suspected small bowel stricture) * Abnormal findings on gastroscopy that may account for bleeding episode: clean-based ulcer \>2 cm or \>5 erosions, esophageal varices, grade C or D erosive esophagitis, vascular malformations * Unable to swallow the capsule endoscopy * Terminal illness * Concomitant use of NSAIDs, sucralfate, rebamepide, antibiotics, corticosteroids (prednisolone \>7.5 mg daily or equivalent), and iron supplement * Pregnancy (except LMP within 7 days) or women of child-bearing age without regular use of contraception * Contraindications to colonoscopy or capsule endoscopy