Before the entire small bowel is imaged by video capsule endoscopy, a high-quality esophagogastroduodenoscopy (EGD) and ileo-colonoscopy should be performed. In several studies, missed sources of bleeding within the reach of a gastroscope or colonoscope were detected in a significant percentage by small bowel capsule endoscopy. Careful inspection and biopsy of the duodenum or the terminal ileum can already give a diagnostic clue. In contrast to noninvasive capsule endoscopy, flexible endoscopy provides the possibility of advanced image enhancement, cleansing of the lumen, delivering therapy, and obtaining biopsies. These options come for the price of potential transmission of infections, patients’ discomfort or the need for sedation. Accordingly, dedicated capsules are expandingly applied for diagnostic endoscopy also for oesophagus, stomach, and colon. Nevertheless, esophago-gastro-duodenoscopy and ileo-colonoscopy remain the gold standard.