Role of capsule endoscopy in inflammatory bowel disease

Abstract

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.

Diagnostic Ionizing Radiation Exposure in a Population-Based Cohort of Patients with Inflammatory Bowel Disease

“…Lastly, capsule endoscopy has emerged as a relatively noninvasive method for direct evaluation of the small bowel mucosa (49)(50)(51)). Yet, individual study sizes have been small, and the yield of CE for the initial diagnosis of CD versus evaluation of recurrent, known disease remains unknown.…”

Capsule endoscopy in inflammatory bowel disease type unclassified and indeterminate colitis serologically negative

“…8 In the setting of IBDU/IC, several studies on the benefit of CE for its evaluation have been published. [6][7][8] These small pilot studies found that the use of CE led to a change in the diagnosis of 29%-40% of patients. 6 A recent multicenter study 7 looked at 30 seronegative IBDU/IC patients with a mean duration of disease of 6 years (range 1-18).…”

“…[6][7][8] These small pilot studies found that the use of CE led to a change in the diagnosis of 29%-40% of patients. 6 A recent multicenter study 7 looked at 30 seronegative IBDU/IC patients with a mean duration of disease of 6 years (range 1-18). An initial CE was positive in 5 patients, with a mean duration of disease of 4 years (range 1-9), who were later diagnosed with CD.…”

“…The available data suggest that CE can identify small-bowel mucosal lesions not observed through other imaging techniques and it may therefore play an important diagnostic role in the evaluation of some patients with known or suspected CD. 6 Several studies have examined the potential role of CE in the setting of IBDU/IC, suggesting that CE is useful in the work-up of these patients by ruling out small-bowel lesions suggestive of CD. [6][7][8] Despite these new developments, a long-term follow-up is often the only way to determine the correct diagnosis.…”

“…6 Several studies have examined the potential role of CE in the setting of IBDU/IC, suggesting that CE is useful in the work-up of these patients by ruling out small-bowel lesions suggestive of CD. [6][7][8] Despite these new developments, a long-term follow-up is often the only way to determine the correct diagnosis. The aim of our study is to evaluate the clinical impact of CE on long-standing IBDU and IC patients with negative serology.…”