The role of small bowel capsule endoscopy and ileocolonoscopy in patients with nonspecific but suggestive symptoms of Crohn’s disease

Mitselos, Ioannis V; Christodoulou, Dimitrios; Κατσάνος, Κωνσταντίνος; Tatsioni, Athina; Rapti, Aleksandra; Eliakim, Rami; Tsianos, Epameinondas V.

doi:10.1097/meg.0000000000000644

Cited by 10 publications

(9 citation statements)

References 61 publications

(65 reference statements)

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“…Thus, ileocolono-scopy is considered to be the first-line investigation for CD and is sufficient to establish the diagnosis in most patients [90]. While the addition of capsule assessment may improve specificity, the discriminatory ability of SBCE was shown in a recent study not to be superior to ileocolonoscopy alone as an initial investigation for CD [91].…”

Section: Suspected Crohn's Diseasementioning

confidence: 99%

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

et al. 2022

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Main Recommendations MR1 ESGE recommends small-bowel capsule endoscopy as the first-line examination, before consideration of other endoscopic and radiological diagnostic tests for suspected small-bowel bleeding, given the excellent safety profile of capsule endoscopy, its patient tolerability, and its potential to visualize the entire small-bowel mucosa.Strong recommendation, moderate quality evidence. MR2 ESGE recommends small-bowel capsule endoscopy in patients with overt suspected small-bowel bleeding as soon as possible after the bleeding episode, ideally within 48 hours, to maximize the diagnostic and subsequent therapeutic yield.Strong recommendation, high quality evidence. MR3 ESGE does not recommend routine second-look endoscopy prior to small-bowel capsule endoscopy in patients with suspected small-bowel bleeding or iron-deficiency anemia.Strong recommendation, low quality evidence. MR4 ESGE recommends conservative management in those patients with suspected small-bowel bleeding and high quality negative small-bowel capsule endoscopy.Strong recommendation, moderate quality evidence. MR5 ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by small-bowel capsule endoscopy.Strong recommendation, high quality evidence. MR6 ESGE recommends the performance of small-bowel capsule endoscopy as a first-line examination in patients with iron-deficiency anemia when small bowel evaluation is indicated.Strong recommendation, high quality evidence. MR7 ESGE recommends small-bowel capsule endoscopy in patients with suspected Crohn’s disease and negative ileocolonoscopy findings as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known bowel stenosis.Strong recommendation, high quality evidence. MR8 ESGE recommends, in patients with unremarkable or nondiagnostic findings from dedicated small-bowel cross-sectional imaging, small-bowel capsule endoscopy as a subsequent investigation if deemed likely to influence patient management.Strong recommendation, low quality evidence. MR9 ESGE recommends, in patients with established Crohn’s disease, the use of a patency capsule before small-bowel capsule endoscopy to decrease the capsule retention rate.Strong recommendation, moderate quality evidence. MR10 ESGE recommends device-assisted enteroscopy (DAE) as an alternative to surgery for foreign bodies retained in the small bowel requiring retrieval in patients without acute intestinal obstruction.Strong recommendation, moderate quality evidence. MR11 ESGE recommends DAE-endoscopic retrograde cholangiopancreatography (DAE-ERCP) as a first-line endoscopic approach to treat pancreaticobiliary diseases in patients with surgically altered anatomy (except for Billroth II patients).Strong recommendation, moderate quality evidence.

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Section: Suspected Crohn's Diseasementioning

confidence: 99%

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

et al. 2022

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“…La afectación del intestino delgado (ID) ocurre en aproximadamente 80% de los pacientes con EC, y en aproximadamente un tercio de ellos la afectación será únicamente del ID 48 .…”

Section: La Ce Es Un Método úTil En El Abordaje Diagnóstico De La Enfermedad Inflamatoria Intestinal Grade 2b (Recomendación Fuerte Calidunclassified

Guía de endoscopia en enfermedad inflamatoria intestinal

Cerna-Cardona¹,

Peláez-Luna²,

Casillas-Guzmán³

et al. 2022

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“…Suspected Crohn's disease patients scheduled for capsule endoscopy, should be carefully selected (17), as the symptoms of abdominal pain and diarrhea, without other accompanying signs, for example extra-intestinal manifestations or elevated inflammatory markers, result in poor diagnostic yield (18)(19)(20)(21). Of note, SBCE is not purposed to substitute esophagogastroduodenoscopy (EGD) in the diagnosis of celiac disease and should only be reserved for patients unwilling to undergo conventional endoscopy (12).…”

Section: Appropriate Indicationsmentioning

confidence: 99%

What defines quality in small bowel capsule endoscopy

Mitselos¹,

Christodoulou²

2018

Ann. Transl. Med.

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Small bowel capsule endoscopy is considered a first-line diagnostic tool for the investigation of small bowel diseases. Gastroenterological and endoscopic societies have proposed and established measures known as quality indicators, quality measures or performance measures for the majority of endoscopic procedures, in order to ensure competence, healthcare quality and define areas requiring improvement. However, there is a paucity of publications describing small bowel capsule endoscopy quality indicators. Hereby, we attempt to identify and describe a number of pre-procedure, intra-procedure and post-procedure quality indicators, regarding process measures in small bowel capsule endoscopy, after a comprehensive review of the literature.

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The role of small bowel capsule endoscopy and ileocolonoscopy in patients with nonspecific but suggestive symptoms of Crohn’s disease

Abstract: IC should be the initial diagnostic test in patients with nonspecific, but suggestive symptoms of CD. SBCE offers additional information on small bowel mucosa and disease extent.

Cited by 10 publications

References 61 publications

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Guía de endoscopia en enfermedad inflamatoria intestinal

What defines quality in small bowel capsule endoscopy

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