Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Na, Soo‐Young; Lim, Yun Jeong

doi:10.3390/diagnostics11122240

Cited by 9 publications

(7 citation statements)

References 102 publications

(134 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CTE is another diagnostic option for detecting CD. However, it is essential to emphasize that, in addition to not exhibiting superiority over MRE or SBCE [16], its effectiveness is hindered by the considerable drawback of ionizing radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy

Singeap,

Sfarti,

Girleanu

et al. 2023

Medicina

View full text Add to dashboard Cite

Background and Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are idiopathic inflammatory bowel diseases (IBDs) without a unique, gold standard diagnostic test. UC and Crohn’s colitis are impossible to distinguish in approximately 10% of cases. The term IBD type unclassified (IBD-U) is recommended for cases of chronic colitis showing overlapping endoscopic, radiological, and biopsy histological features between UC and CD, while indetermined colitis is reserved for colectomy specimens. Our aim was to assess the role of small-bowel capsule endoscopy (SBCE) in the diagnostic work-up of IBD-U. Materials and Methods: We retrospectively studied the cases of IBD-U explored by SBCE in a tertiary referral gastroenterology center. Patients were investigated using SBCE after contraindications were excluded. Diagnostic criteria for small bowel CD consisted in more than three ulcerations, irregular ulcers, or stenosis, and the Lewis score was used for the quantification of inflammation. The immediate impact of reclassification and outcome data was recorded over a follow-up period of more than one year. Results: Twenty-eight patients with IBD-U were examined using SBCE. Nine patients had small bowel lesions that met the diagnostic criteria for CD, resulting in a reclassification rate of 32.1%. In five of these cases, the treatment was subsequently changed. In the remaining nineteen examinations, no significant findings were observed. There were no complications associated with SBCE. Median follow-up time was 32.5 months (range 12–60). During follow-up, twelve patients were classified as having UC, and seven remained as having an unclassified type; one case of colectomy, for medically refractory UC, was recorded. Conclusions: SBCE is a useful safe tool in the work-up of IBD-U, allowing reclassification in about one third of cases, with subsequent treatment modifications. SBCE may provide a definite diagnosis, enhance the comprehension of the disease’s progression, and optimize the short- and long-term management strategy.

show abstract

Section: Discussionmentioning

confidence: 99%

Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy

Singeap,

Sfarti,

Girleanu

et al. 2023

Medicina

View full text Add to dashboard Cite

show abstract

“…Colonoscopy and small bowel capsule endoscopy have a definite role in the management of patients with IBD [ 12 ]. The advent of PCE, allowing concomitant enteric and colonic evaluation, has created the expectation that this modality may allow a comfortable and accurate evaluation of the GI involvement in IBD in a single examination [ 3 , 13 ]. Moreover, for IBD evaluation, patients are often submitted to separate colonic and small bowel evaluations, the latter frequently by radiologic exams.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…Scoring systems allow for the standardization of reporting, increasing reproducibility and interobserver agreement [ 23 ]. Whereas most scores have been established for colonoscopy and small bowel CE, their application in PCE to monitor IBD mucosal disease activity has also been proposed [ 13 ]. Niv et al [ 24 ] extended the validated Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI) score to include the colon, introducing the novel CECDAIic score, allowing for an objective pan-enteric assessment of CD inflammatory activity [ 25 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Pan-Enteric Capsule Endoscopy: Current Applications and Future Perspectives

Rosa,

Andrade,

Lopes

et al. 2023

GE Port J Gastroenterol

View full text Add to dashboard Cite

Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (pan-enteric capsule endoscopy [PCE]). Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn’s disease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syndromes with simultaneous involvement of the small intestine and colon. Key Messages: PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.

show abstract

“…In a comparison study, CECDAI emerged as a simpler and more accurate indicator of active small bowel inflammation than LS [55]. CECDAI was validated in multicenter prospective study of patients with isolated small-bowel CD [129], summing up the score in the proximal and distal portions of SB (based on transit time) across the three endoscopic parameters:: inflammation (A, 0 to 5 points), extent of disease (B, 0 to 3 points), and strictures (C, 0 to 3 points), both for the proximal and distal 10 segments of the small bowel based on the transit time of the capsule (Table 3). Even if no clear cut-off for inflammatory severity has been validated for the CECDAI score, the values of 3.…”

Section: Scoring Systemsmentioning

confidence: 99%

Capsule Endoscopy in Suspected and Established Small Bowel Crohn’s Disease

Mastronardi,

Cavalcanti

2023

Crohn’s Disease - The Current State of the Art

View full text Add to dashboard Cite

Capsule endoscopy has recognized to be a very useful non-invasive tool for diagnosis and evaluation of the extension or the recurrence in Crohn’s disease (CD) patients. It has the advantage of outstanding visualization of small-bowel lesions undetectable by conventional endoscopy or radiologic studies and has a good tolerability and safety in well-selected patients. In this chapter, we would like to evaluated the significant small bowel capsule endoscopy findings that can lead to better outcomes of diagnosis, classification, therapeutic management, and prognosis of patients with CD. Moreover, we would to discuss the specificity of the CE and to determine the place of the CE in the recurrence of CD and, for example, its role in monitoring drug response.

show abstract

Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Cited by 9 publications

References 102 publications

Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy

Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy

Pan-Enteric Capsule Endoscopy: Current Applications and Future Perspectives

Capsule Endoscopy in Suspected and Established Small Bowel Crohn’s Disease

Contact Info

Product

Resources

About