Diagnosing small bowel Crohn's disease with wireless capsule endoscopy

Abstract

Background: The small bowel is the most commonly affected site of Crohn's disease (CD) although it may involve any part of the gastrointestinal tract. The current methodologies for examining the small bowel are x ray and endoscopy. Aims: To evaluate, for the first time, the effectiveness of wireless capsule endoscopy in patients with suspected CD of the small bowel undetected by conventional modalities, and to determine the diagnostic yield of the M2A Given Capsule. Patients: Seventeen patients (eight males, mean age 40 (15) years) with suspected CD fulfilled study entry criteria: nine had iron deficiency anaemia (mean haemoglobin 10.5 (SD 1.8) g%), eight had abdominal pain, seven had diarrhoea, and three had weight loss. Small bowel x ray and upper and lower gastrointestinal endoscopic findings were normal. Mean duration of symptoms before diagnosis was 6.3 (SD 2.2) years. Methods: Each subject swallowed an M2A Given Capsule containing a miniature video camera, batteries, a transmitter, and an antenna. Recording time was approximately eight hours. The capsule was excreted naturally in the patient's bowel movement, and the data it contained were retrieved and interpreted the next day. Results: Of the 17 study participants, 12 (70.6%, six males, mean age 34.5 (12) years) were diagnosed as having CD of the small bowel according to the findings of the M2A Given Capsule. Conclusions: Wireless capsule endoscopy diagnosed CD of the small bowel (diagnostic yield of 71%). It was demonstrated as being an effective modality for diagnosing patients with suspected CD undetected by conventional diagnostic methodologies.

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohn’s disease

“…Diagnosis of lesions suggestive of SB-CD, as described in the literature (9), was based on the observation of villous edema and erythema, mucosal denudation, erosive lesions as aphthae or ulcers, and the presence of stenosis ( Figs. 1 and 2).…”

Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

“…However, videocapsule retention requiring surgical or endoscopic removal occurs most commonly in patients with Crohn's disease or small bowel diaphragms associated with the use of NSAIDs [10]. The retention rate is between 4-13% in those with known Crohn's disease [11][12][13] and between 1-2% in patients with suspicion of this disease [13][14][15]. As regards small bowel diaphragms produced by NSAIDs, this has resulted in the retention of the videocapsule at a rate of 1.1% in 1,000 patients with various indications for examination with endoscopic videocapsule analyzed in a retrospective study [16].…”

Capsule Endoscopy: A Comprehensive Review

“…diagnosis of small bowel CD (Papadakis et al,2005) has been examined in several studies and found to be superior to small bowel follow-through (Fireman et al .,2003;Herrerias et al, 2003;Mow et al,2004Mow et al, ), enteroclysis (chong et al,2005Liangpunsakul et al,2003), push enteroscopy (chong et al,2005) and CT enteroclysis (Voderholzer et al,2005) for identifying small intestinal disease. the Diagnostic yield of CE was compared with other modalities in patients with suspected small bowel CD, yield of CE was 63% compared with 23% for barium radiography.…”