Capsule endoscopy has been shown to detect small bowel inflammatory changes better than any other imaging modality. Selection criteria have been optimized to increase the yield of capsule endoscopy in patients suspected of having Crohn’s disease. Capsule endoscopy allows for earlier diagnosis of Crohn’s disease of the small bowel and improved diagnosis of colitis in patients where it is unclear if they suffer from Crohn’s or ulcerative colitis. A test capsule is available to assess for small bowel strictures and thus avoid capsule retention. It is envisioned that the manner in which we treat Crohn’s disease in the future will change, based on earlier diagnosis and treatment aimed at mucosal healing rather than symptom improvement.

Keywords:
Crohn’s disease, Capsule retention, Mucosal healing, Capsule endoscopy
1.
Shivananda S, Lennard-Jones J, Logan R, Fear N, Price A, Carpenter L, van Blankenstein M: Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Gut 1996;39:690–697.
2.
Satsangi J, Silverberg MS, Vermeire S, Colombel JF: The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55:749–753.
3.
Molinié F, Gower-Rousseau C, Yzet T, Merle V, Grandbastien B, Marti R, Lerebours E, Dupas JL, Colombel JF, Salomez JL, Cortot A: Opposite evolution in incidence of Crohn’s disease and ulcerative colitis in Northern France (1988–1999). Gut 2004;53:843–848.
4.
Lashner B: Clinical features, laboratory findings, and course of Crohn’s disease; in Kirsner JV (ed): Inflammatory Bowel Disease, ed 5. Philadelphia, Saunders, 2000, pp 305–314.
5.
Dionisio PM, Gurudu SR, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, Heigh RI, Shiff AD, Sharma VK: Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small-bowel Crohn’s disease: a meta-analysis. Am J Gastroenterol 2010;105:1240–1248.
6.
Spada C, Pirozzi GA, Riccioni ME, Iacopini F, Marchese M, Costamagna G: Capsule endoscopy in patients with chronic abdominal pain. Dig Liver Dis 2006;38:696–698.
7.
Fry LC, Carey EJ, Shiff AD, Heigh RI, Sharma VK, Post JK, Hentz JG, Fleischer DE, Leighton JA: The yield of capsule endoscopy in patients with abdominal pain or diarrhea. Endoscopy 2006;38:498–502.
8.
May A, Manner H, Schneider M, Ipsen A, Ell C: Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study). Endoscopy 2007;39:606–612.
9.
Fireman Z, Mahajna E, Broide E, Shapiro M, Fich L, Sternberg A, Kopelman Y, Scapa E: Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy. Gut 2003;52:390–392.
10.
Mergener K, Ponchon T, Gralnek I, Pennazio M, Gay G, Selby W, Seidman EG, Cellier C, Murray J, de Franchis R, Rösch T, Lewis BS: Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/ 2007. Endoscopy 2007;39:895–909.
11.
Albert JG, Martiny F, Krummenerl A, et al: Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut 2005;54:1721–1727.
12.
Crook DW, Knuesel PR, Froehlich JM, et al: Comparison of magnetic resonance enterography and video capsule endoscopy in evaluating small bowel disease. Eur J Gastroenterol Hepatol 2009;21:54–65.
13.
Tillack C, Seiderer J, Brand S, et al: Correlation of magnetic resonance enteroclysis in the diagnosis of small bowel lesions in Crohn’s disease. Inflamm Bowel Dis 2008;14:1219–1228.
14.
Golder SK, Schreyer AG, Endlicher E, et al: Comparison of capsule endoscopy and magnetic resonance enteroclysis in suspected small bowel disease. Int J Colorectal Dis 2006;21:97–104.
15.
Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M: Predictability of the postoperative course of Crohn’s disease. Gastroenterology 1990;99:956–963.
16.
Olaison G, Smedh K, Sjödahl R: Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms. Gut 1992;33:331–335.
17.
Bourreille A, Jarry M, D’Halluin PN, Ben-Soussan E, Maunoury V, Bulois P, Sacher-Huvelin S, Vahedy K, Lerebours E, Heresbach D, Bretagne JF, Colombel JF, Galmiche JP: Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn’s disease: a prospective study. Gut 2006;55:978–983.
18.
Pons Beltrán V, Nos P, Bastida G, Beltrán B, Argüello L, Aguas M, Rubín A, Pertejo V, Sala T: Evaluation of postsurgical recurrence in Crohn’s disease: a new indication for capsule endoscopy? Gastrointest Endosc 2007;66:533–540.
19.
Su C, Lewis JD, Goldberg B, Brensinger C, Lichtenstein GR: A meta-analysis of the placebo rates of remission and response in clinical trials of active ulcerative colitis. Gastroenterology 2007;132:516–526.
20.
Rutgeerts P, Diamond RH, Bala M, Olson A, Lichtenstein GR, Bao W, Patel K, Wolf DC, Safdi M, Colombel JF, Lashner B, Hanauer SB: Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn’s disease. Gastrointest Endosc 2006;63:433–442.
21.
Price AB: Overlap in the spectrum of non-specific inflammatory bowel disease – ‘colitis indeterminate’. J Clin Pathol 1978;31:567–577.
22.
Geboes K, Colombel JF, Greenstein A, Jewell DP, Sandborn WJ, Vatn MH, Warren B, Riddell RH; Pathology Task Force of the International Organization of Inflammatory Bowel Diseases: Indeterminate colitis: a review of the concept – what’s in a name? Inflamm Bowel Dis 2008;14:850–857.
23.
Guindi M, Riddell RH: Indeterminate colitis. J Clin Pathol 2004;57:1233–1244.
24.
Mow WS, Lo SK, Targan SR, Dubinsky MC, Treyzon L, Abreu-Martin MT, Papadakis KA, Vasiliauskas EA: Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hepatol 2004;2:31–40.
25.
Maunoury V, Savoye G, Bourreille A, Bouhnik Y, Jarry M, Sacher-Huvelin S, Ben Soussan E, Lerebours E, Galmiche JP, Colombel JF: Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified). Inflamm Bowel Dis 2007;13:152–155.
26.
Mehdizadeh S, Chen G, Enayati PJ, Cheng DW, Han NJ, Shaye OA, Ippoliti A, Vasiliauskas EA, Lo SK, Papadakis KA: Diagnostic yield of capsule endoscopy in ulcerative colitis and inflammatory bowel disease of unclassified type. Endoscopy 2008;40:30–35.
27.
Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, Lewis BS: The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease. Am J Gastroenterol 2006;101:2218–2222.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.