Does clinical response correlate with mucosal healing in patients with Crohnʼs disease of the small bowel? A prospective, case-series study using wireless capsule endoscopy

“…The use of CE for (non-fistulizing or penetrating) CD has shown ulcer improvement at 1 month after treatment (70). As is the case with colonic lesions, such healing does not correlate with clinical manifestations (71).…”

Section: Mucosal Healingmentioning

confidence: 99%

Indications of capsule endoscopy in Crohn's disease

Luján-Sanchis

Sanchis-Artero

Suárez-Callol

et al. 2014

Rev. esp. enferm. dig.

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Capsule endoscopy currently plays a relevant role for Crohn's disease. This manuscript will discuss the current indications and practical uses of capsule endoscopy in this disease. It is a non-invasive technique that represents a significant advance in the endoscopic diagnosis of small bowel conditions. These circumstances, together with its diagnostic yield and excellent tolerability, make it considerably acceptable by both patients and physicians. This paper discusses the current evidence on the specific circumstances where capsule endoscopy may be indicated for three specific scenarios: Suspected Crohn's disease, indeterminate colitis, and established Crohn's disease, where it plays an extensive role. Furthermore, the impact and implications of capsule endoscopy results for follow-up are reviewed. These recommendations must be interpreted and applied in the setting of the integral, individual management of these patients. Understanding its appropriate use in daily clinical practice and an analysis of results may define endoscopic scoring systems to assess activity and mucosal healing in this condition. The present role of capsule endoscopy for Crohn's disease is subject to ongoing review, and appropriate usage uncovers novel applications likely to result in relevant changes for the future management of these patients.

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“…Conventional ileocolonoscopy is the current gold-standard modality for assessment of mucosal healing. A small prospective study had evaluated monitoring of mucosal healing with VCE performed before and after treatment for acute CD flare-up [28] . Forty patients with CD flares were included in the study and all have responded to treatment within 4-8 wk of treatment.…”

Section: Vce In Established CDmentioning

confidence: 99%

“…In one study, VCE detected CD recurrence in 15 (62%) patients, whereas ileocolonoscopy detected inflammatory lesions in the neo-terminal ileum in only 6 (25%) patients [32] . VCE was also evaluated for a potential role in the assessment of mucosal healing after drug therapy in CD [28] .…”

Section: Postoperative Recurrencementioning

confidence: 99%

Role of capsule endoscopy in inflammatory bowel disease

Leighton

Legnani

Seidman

2007

Inflammatory Bowel Diseases

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Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn's disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an important tool in the management of patients with unclassified inflammatory bowel disease, potentially resulting in reclassification of these patients as having CD. Reports on postoperative monitoring and evaluation of patients with ileal pouch-anal anastomosis who have developed pouchitis have recenty been published. Monitoring of colonic inflammatory activity in patients with ulcerative colitis using the recently developed colonic capsule has also been reported. Capsule endoscopy is associated with an excellent safety profile. Although retention risk is increased in patients with small bowel CD, this risk can be significanty decreased by a routine utilization of a dissolvable patency capsule preceding the ingestion of the diagnostic capsule. This paper contains an overview of the current and future WJG 20 th Anniversary Special Issues (3): Inflammatory bowel disease TOPIC HIGHLIGHTclinical applications of capsule endoscopy in inflammatory bowel disease.

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Does clinical response correlate with mucosal healing in patients with Crohnʼs disease of the small bowel? A prospective, case-series study using wireless capsule endoscopy

Abstract: Since only 1 out of 3 endoscopic variables improved significantly with treatment, we can conclude that clinical response does not seem to correlate with mucosal healing in patients with CD of the small bowel.

Cited by 109 publications

References 27 publications

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Indications of capsule endoscopy in Crohn's disease

Role of capsule endoscopy in inflammatory bowel disease

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