Clin Endosc.  2018 Nov;51(6):570-575. 10.5946/ce.2018.055.

Capsule Endoscopy in Refractory Diarrhea-Predominant Irritable Bowel Syndrome and Functional Abdominal Pain

  • 1Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador.


Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain.
This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included. Capsule endoscopy was used to detect small bowel pathologies in both groups.
Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (±standard deviation) age of 50.9±15.9 years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% of the patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominal pain and the diarrhea groups, respectively.
Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, in patients with refractory conditions, capsule endoscopy may identify abnormalities.


Capsule endoscopy; Irritable bowel syndrome; Refractory

MeSH Terms

Abdominal Pain*
Capsule Endoscopy*
Irritable Bowel Syndrome*
Prospective Studies
Retrospective Studies


  • Fig. 1. Flowchart describing the process of population selection. NSAID, nonsteroidal anti-inflammatory agent; D-IBS, diarrhea-predominant irritable bowel syndrome.

  • Fig. 2. Capsule endoscopy (CE) findings. (A) Ascariasis found in the small intestine in a patient with persistent abdominal pain, (B) ulcer identified by CE in the terminal ileum. Crohn’s disease was confirmed by histopathology of an enteroscopic sample, (C) sub-mucosal tumor in the upper jejunum, (D) villous atrophy detected by CE in jejunum.

Cited by  2 articles

Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience
Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park
Clin Endosc. 2021;54(1):85-91.    doi: 10.5946/ce.2020.047.

Refractory Irritable Bowel Syndrome and Functional Abdominal Pain Syndrome: Should Small Bowel Endoscopy Be Performed?
Sung Kyun Yim, Sang Wook Kim
Clin Endosc. 2018;51(6):508-509.    doi: 10.5946/ce.2018.157.


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