Colon Capsule Endoscopy for Inflammatory Bowel Disease

Hosoe, Naoki; Hayashi, Yukie; Ogata, Haruhiko

doi:10.5946/ce.2019.156

Cited by 12 publications

(21 citation statements)

References 27 publications

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“…Only three of seven with colitis on colonoscopy ended up with a diagnosis of UC. This is dif-▶ ficult to explain as previous studies and those with modern capsules have found a high rate of diagnostic accuracy in IBD [9,16]. For very distal limited proctitis the process of excretion may affect video interpretation, with distal inflammation being mis-classified as a normal rectal cushion.…”

Section: Discussionmentioning

confidence: 97%

“…As such, evaluation of symptomatic patients still represents a significant burden for colonoscopy services and viable alternatives are needed to help meet increasing demand 8 . There is now an abundance of evidence to show CCE is an effective means to detect both neoplastic and non-neoplastic disease in selected patient cohorts including Inflammatory Bowel Disease patient assessment, average and low risk screening, after incomplete colonoscopy and polyp surveillance 9 10 11 12 13 14 15 . However, the efficacy of CCE in an unselected average risk symptomatic cohort, with or without biomarker vetting is less clear.…”

Section: Introductionmentioning

confidence: 99%

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Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

Semenov

Sihag

et al. 2021

Endosc Int Open

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Background and study aims Colon capsule endoscopy (CCE) is a recommended viable alternative to colonoscopy for colonic visualisation in a variety of clinical settings with proven efficacy in polyp detection, surveillance, screening and Inflammatory Bowel Disease (IBD) assessment. CCE efficacy in an unselected average risk symptomatic cohort has yet to be established. The aim of this study was to determine the feasibility of CCE imaging assessment in average risk symptomatic patients as an alternative to colonoscopy with and without additional biomarker assessment. Patients and methods This was a prospective, single-center comparison study of colonoscopy, CCE and biomarker assessment. Results Of 77 invited subjects, 66 underwent both a CCE and colonoscopy. A fecal immunochemical test (FIT) and fecal calprotectin (FC) were available in 56 and 59 subjects. In all 64 % (n = 42) had any positive finding with 16 (24 %) found to have significant disease (high-risk adenomas, IBD) on colonoscopy. The CCE completion rate was 76 %, five (8 %) had an inadequate preparation, the CCE polyp detection rate was high at 35 %. The sensitivity, specificity, positive and negative predictive values of CCE for significant disease were 81 %, 98 %, 93 % and 94 % respectively. In addition, three (5 %) significant small bowel diagnoses were made on CCE. FC and FIT were frequently elevated in patients with both colitis (5/7, 71 %) and high-risk adenomas (4/7 57 %). While both had a low positive predictive value for clinically significant disease, FIT 32 % and FC 26 %. Conclusions CCE is a safe and effective alternative to colonoscopy in symptomatic average risk patients with or without the addition of biomarker screening.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

Semenov

Sihag

et al. 2021

Endosc Int Open

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“…Interestingly of these 31 patients, 77.4% (24/31) would still choose to have CCE as rst line even with the knowledge that they may have to have a colonoscopy as a second procedure if further investigation or intervention was required. As explained in the introduction, CCE has proven e cacy in a variety of clinical situations and can be used in both the symptomatic and screening cohort (11)(12)(13)(14)(15)(16)(17)(18)(19). As such, we would like to recommend Clinicians include alternatives to colonoscopy such as CCE when discussing available investigations with patients.…”

Section: Discussionmentioning

confidence: 99%

“…CCE has proven e cacy to detect both neoplastic and non-neoplastic disease in selected patient cohorts including In ammatory Bowel Disease patient assessment, average and low risk colorectal cancer screening, after incomplete colonoscopy and polyp surveillance (11)(12)(13)(14)(15)(16)(17)(18)(19). A recently published study from our centre also has shown that CCE had a sensitivity, speci city, positive predictive value (PPV), negative predictive value (NPV) of 81%, 98%, 93% and 94% respectively in a symptomatic cohort when compared to colonoscopy (1).…”

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confidence: 99%

Comparing Colon Capsule Endoscopy To Colonoscopy; A Symptomatic Patient’s Perspective

Murphy

Semenov

et al. 2021

Preprint

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Introduction:Colon Capsule Endoscopy (CCE) has proven efficacy in a variety of gastrointestinal diseases. Few studies have assessed patient-reported outcomes and preference between colonoscopy and CCE.Aims:To identify comfort scores and patient preferences between CCE and colonoscopy.Methods:Patients from our centre who had both a CCE and colonoscopy within a 12-month period were identified. We performed over-the-phone interviews focused on satisfaction, comfort, and overall preference with a 10-point Likert scale. Electronic records were reviewed; reported Modified-Gloucester-Comfort-Scale (GCS) score, sedation, bowel preparation and endoscopist grade were documented. Data was compared between procedures. A Fishers exact test was used to compare proportions and a Student t-test was used to compare means, a p < 0.05 was considered significant.Results:In all, 40 patients were identified, 57.5% (23/40) were female and the mean age was 48 years (24 – 78). All patients were referred for investigation of lower gastrointestinal symptoms as part of an ongoing study (1).There was a significance difference in mean comfort (9.2 vs 6.7, p<0.0001, 95% CI -3.51 to -1.44) but not satisfaction (8.3 vs 7.7, p=0.2, 95% CI -1.48 to 0.33) between CCE and colonoscopy. Main cause of dissatisfaction with CCE was bowel preparation and for colonoscopy was discomfort. Age and gender were not found to be variables. The correlation between GCS and patient reported values was weak (R = -0.28).Overall, 77.5% (31/40) of patients would prefer a CCE if they required further bowel investigation. Of these, 77.4% (24/31) preferred a CCE despite the potential need for follow-up colonoscopy.Conclusions:CCE has a high satisfaction rating (8.3 vs 7.7) and has a higher patient reported comfort rating (9.2 vs 6.7) than colonoscopy. Studies have confirmed CCE and colonoscopy have equivalent diagnostic yields. The majority of patients in our cohort prefer CCE to colonoscopy. CCE should be considered as an alternative to colonoscopy in selected individuals.

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“…CCE is an effective tool to noninvasively assess mucosal disease activity in inflammatory bowel disease (IBD), enabling the monitoring of response to treatment, determine mucosal healing, and surveillance. With the introduction of higher-accuracy second-generation CCE (PillCam ® COLON-2), the CCE’s usefulness for the noninvasive assessment of mucosal disease activity is currently being explored [ 16 ].…”

Section: Mucosal Disease Activity In Inflammatory Bowel Diseasementioning

confidence: 99%

Scoring Systems for Clinical Colon Capsule Endoscopy—All You Need to Know

Tabone

Koulaouzidis

Ellul

2021

JCM

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In the constantly developing era of minimal diagnostic invasiveness, the role of colon capsule endoscopy in colonic examination is being increasingly recognised, especially in the context of curtailed endoscopy services due to the COVID-19 pandemic. It is a safe diagnostic tool with low adverse event rates. As with other endoscopic modalities, various colon capsule endoscopy scores allow the standardisation of reporting and reproducibility. As bowel cleanliness affects CCE’s diagnostic yield, a few operator-dependent scores (Leighton–Rex and CC-CLEAR scores) and a computer-dependent score (CAC score) have been developed to grade bowel cleanliness objectively. CCE can be used to monitor IBD mucosal disease activity through the UCEIS and the panenteric CECDAIic score for UC and CD, respectively. CCE may also have a role in CRC screening, given similar sensitivity and specificity rates to conventional colonoscopy to detect colonic polyps ≥ 10 mm and CRC. Given CCE’s diagnostic yield and reproducible clinical scores with high inter-observer agreements, CCE is fast becoming a suitable alternative to conventional colonoscopy in specific patient populations.

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Colon Capsule Endoscopy for Inflammatory Bowel Disease

Cited by 12 publications

References 27 publications

Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

Comparing Colon Capsule Endoscopy To Colonoscopy; A Symptomatic Patient’s Perspective

Scoring Systems for Clinical Colon Capsule Endoscopy—All You Need to Know

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