Capsule Endoscopy Findings in Celiac Disease

Abstract

Capsule endoscopy (CE) is a noninvasive imaging method used to evaluate intestinal mucosa. We aimed to examine intestinal mucosal changes in celiac disease (CD) with CE. Eight untreated patients who had anti-endomysial antibody-positive duodenal biopsy results consistent with CD were included in the study. Villous atrophy, scalloping, fissuring, and mosaic pattern (consistent with CD) were detected in seven patients; one patient was excluded for early meal consumption. No patchy involvement was found in the intestine or distal region of the intestine (ileum) in any of the patients. The common feature of all patients was that villous atrophy, scalloping, fissuring, and mosaic patterns detected in the proximal intestine gradually decreased towards the distal intestine. CE provided no diagnostic contribution to CD when compared with duodenal biopsy. It can be used to show villous atrophy in selected cases and to evaluate the extension of intestinal involvement in CD.

The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study

“…For example, in adult practice the third commonest indication is for coeliac disease despite the sensitivity of WCE being far from 100% for more subtle grades of villous atrophy 29. In childhood there are many different causes of enteropathy often with patchy mild changes for which the sensitivity of WCE is low.…”

“…Since the United States Food and Drug Administration (FDA) approved the use of WCE in patients >10 years in 2001 the technique has been shown to be a safe with no pain and few complications 5 6 7 8 9 10 11 12 13 14. The knowledge obtained since its introduction has provided new insights into a variety of diseases15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 and has altered the management of patients with small intestinal diseases previously investigated with little success by a variety of endoscopic and radiological techniques 3 9 14 15…”

Wireless capsule endoscopy as a tool in diagnosing autoimmune enteropathy

“…WCE is a valuable diagnostic tool in a variety of diseases where mucosal damage is involved, such as coeliac disease and refractory coeliac disease 12. However, in coeliac disease, capsule endoscopy does not contribute to diagnosis when compared with duodenal biopsies 13. In our cases, the capsule endoscopy raised suspicion of an enteropathy affecting the entire small bowel different from coeliac disease.…”

Increased Sedation Requirements During Endoscopy in Patients with Celiac Disease

“…Therefore, altered effects from sedation may result from a mechanism apart from visceral hypersensitivity or anxiety. Moreover, these differences in sedation requirements may reflect other underlying gastrointestinal pathology leading to acute or intermittent abdominal pain, such as intussusception [22,23].…”