Intest Res.  2020 Jul;18(3):265-274. 10.5217/ir.2019.09165.

Capsule endoscopy in inflammatory bowel disease: when and how

• Hilmi I
• Kobayashi T

• KMID: 2504581
• DOI: http://doi.org/10.5217/ir.2019.09165

Abstract

Capsule endoscopy (CE) is emerging as an important investigation in inflammatory bowel disease (IBD); common types include the standard small bowel CE and colon CE. More recently, the pan-enteric CE was developed to assess the large and small bowel in patients with Crohn’s disease (CD). Emerging indications include noninvasive assessment for mucosal healing (both in the small bowel and the colon) and detection of postoperative recurrence in patients with CD. Given the increasing adoption, several CE scoring systems have been specifically developed for IBD. The greatest concern with performing CE, particularly in CD, is capsule retention, but this can be overcome by performing cross-sectional imaging such as magnetic resonance enterography and using patency capsules before performing the procedure. The development of software for automated detection of mucosal abnormalities typically seen in IBD may further increase its adoption.

Keyword

Capsule endoscopy; Crohn disease; Colitis, ulcerative; Inflammatory bowel disease

Figure

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  Fig. 1. Types of capsule endoscopy. (A) PillCam Small Bowel Capsule 3 (SB3; Given Imaging Ltd.), (B) MiroCam capsule (Intromedic), and (C) PillCam Colon Capsule Endoscopy 2 (Given Imaging Ltd.).

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  Fig. 2. Endoscopic (A) and computed tomography (B) images of a retained capsule.

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  Fig. 3. Patency capsules (A) intact, (B) partially dissolved, and (C) fully dissolved.

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  Fig. 4. Suggested algorithm for capsule endoscopy in patients with suspected Crohn’s disease. IBD, inflammatory bowel disease; CT, computed tomography; GI, gastrointestinal.

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  Fig. 5. Suggested algorithm for capsule endoscopy in patients with confirmed Crohn’s disease (CD). MRE, magnetic resonance enterography; CTE, computed tomography enterography.

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  Fig. 6. Suggested algorithm for capsule endoscopy in patients with ulcerative colitis (UC).

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