Capsule endoscopy findings in patients with suspected Crohn's disease and biochemical markers of inflammation

Bona, Manuela De; Bellumat, Angelo; Cian, E.; Valiante, F.; Moschini, A.; Boni, Michele De

doi:10.1016/j.dld.2006.02.004

Cited by 42 publications

(30 citation statements)

References 13 publications

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“…The small numbers of patients in the existing studies preclude definite conclusions, but it appears that CE-guided treatment leads to symptom resolution in the majority of patients with either established or suspected Crohn's disease. Our study and previous reports [15][16][17] suggest that the presence of anemia and elevated markers of inflammation increases the diagnostic yield in patients with chronic abdominal pain and chronic diarrhea or with suspected Crohn's disease. Therefore, better selection of patients with gastrointestinal symptoms will likely improve the cost effectiveness of CE.…”

Section: Discussionmentioning

confidence: 49%

Can Capsule Endoscopy Be Used as a Diagnostic Tool in the Evaluation of Nonbleeding Indications in Daily Clinical Practice? A Prospective Study

et al. 2011

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Objective: To evaluate the diagnostic yield of capsule endoscopy (CE) and its impact on treatment and outcome in patients without bleeding indications. Subjects and Methods: One hundred and sixty-five nonbleeding patients were enrolled in the study. The most common indications for CE were chronic abdominal pain alone (33 patients) or combined with chronic diarrhea (31 patients) and chronic diarrhea alone (30 patients). Among the 165 patients, 129 underwent CE for evaluation of gastrointestinal symptoms and 36 for surveillance or disease staging. Results: CE findings were positive, suspicious and negative in 73 (44.2%), 13 (7.9%) and 79 (47.9%) of cases, respectively. The diagnostic yield was highest in patients with refractory celiac disease (10/10, 100%) and suspected Crohn’s disease (5/6, 83.3%), followed by patients with chronic abdominal pain and chronic diarrhea (13/31, 41.9%), established Crohn’s disease (2/6, 33.3%), chronic diarrhea alone (8/30, 26.7%), chronic abdominal pain alone (8/33, 24.2%) and other indications (3/13, 23.1%) (p < 0.005). The CE findings led to a change of medication in 74 (47.7%) patients, surgery in 15 (9.7%), administration of a strict gluten-free or other special diet in 13 (8.4%) and had other consequences in 11 (6.7%). Management was not modified in 42 (27.1%) patients. Among symptomatic patients (n = 129), 29 (22.5%) were lost to follow-up. The remaining 100 patients were followed up for 8.7 ± 4.0 months (range 2–19). Among the latter, resolution or improvement of symptoms was observed in 86 (86%) patients, no change in 11 (11%) and 3 (3%) died. All 86 patients who experienced resolution or improvement of their symptoms had a modification of their management after CE; only 7/11 patients whose symptoms did not change (63.6%) and 2/3 patients who died (66.7%) had a modification of management (p < 0.001). Conclusions: CE appears to be a useful tool in the evaluation of patients with nonbleeding indications. The outcome of most patients with negative findings was excellent.

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Section: Discussionmentioning

confidence: 49%

Can Capsule Endoscopy Be Used as a Diagnostic Tool in the Evaluation of Nonbleeding Indications in Daily Clinical Practice? A Prospective Study

et al. 2011

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“…These include biochemical markers of inflammation such as raised C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) [174], thrombocytosis [175], anaemia, faecal markers of inflammation (e. g., calprotectin, lactoferrin), and symptoms of abdominal pain, diarrhoea [176], or weight loss [177]. Recurrent abdominal pain without other findings exceptionally rarely results in detection of clinically relevant lesions in the small bowel [178,179], little different from colonoscopy for isolated abdominal pain.…”

Section: Management Of Complications 731 Capsule Retentionmentioning

confidence: 99%

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

Bourreille¹,

Ignjatovic²,

Aabakken³

et al. 2009

Endoscopy

304

185

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“…Further, CE provides evidence not only to diagnose a patient having CD but also exclude CD and discriminate CD from indeterminate colitis. The rate of diagnosis of CD in patients with suspected CD depends on the study, which was 12.5-70.6% in adult (Cheifetz, 2006;De Bona, 2006;Fireman, 2003), and 50-55% in children (de'Angelis, 2007;Fritscher-Ravens, 2009;Guilhon de Araujo Sant'Anna, 2005), thus criteria of suspected CD will be an important issue of concern.…”

Section: Chron's Disease or Inflammatory Bowel Diseasementioning

confidence: 99%

Wireless Capsule Endoscopy in Pediatric Gastrointestinal Diseases

Tokuhara¹

2011

New Techniques in Gastrointestinal Endoscopy

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Capsule endoscopy findings in patients with suspected Crohn's disease and biochemical markers of inflammation

Cited by 42 publications

References 13 publications

Can Capsule Endoscopy Be Used as a Diagnostic Tool in the Evaluation of Nonbleeding Indications in Daily Clinical Practice? A Prospective Study

Can Capsule Endoscopy Be Used as a Diagnostic Tool in the Evaluation of Nonbleeding Indications in Daily Clinical Practice? A Prospective Study

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

Wireless Capsule Endoscopy in Pediatric Gastrointestinal Diseases

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