Review
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World J Gastrointest Endosc. May 16, 2010; 2(5): 179-185
Published online May 16, 2010. doi: 10.4253/wjge.v2.i5.179
Role of wireless capsule endoscopy in inflammatory bowel disease
Eduardo Redondo-Cerezo
Eduardo Redondo-Cerezo, Endoscopy Unit, Gastroenterology and Hepatology Department, The University Hospital Virgen de las Nieves, Granada 18014, Spain
Author contributions: Redondo-Cerezo E contributed solely to this paper.
Correspondence to: Eduardo Redondo-Cerezo, MD, PhD, Endoscopy Unit, Servicio de Aparato Digestivo, Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas 2, Granada 18014, Spain. eredondoc@yahoo.es
Telephone: +34-95-8020146
Received: February 2, 2010
Revised: April 24, 2010
Accepted: May 1, 2010
Published online: May 16, 2010
Abstract

Capsule endoscopy (CE) offers state-of-the-art imaging of the small bowel. In Crohn’s disease its clinical role is still uncertain. This report analyses the usefulness of CE in patients with suspected Cronh’s disease, in patients with established Crohn’s disease (when assessing severity, occult gastrointestinal bleeding and/or as a guide to therapy), in patients with inflammatory bowel disease unclassified (IBDU), and in individuals with ulcerative colitis. The first item in this group is the most important although there is no strong evidence to establish the position of CE in the diagnostic workup. In patients with established Crohn’s disease, recently developed activity scores are promising tools for an accurate assessment of severity. As a guide to therapy, CE should be focused on patients with unexplained symptoms when other investigations are inconclusive. In postoperative Crohn’s Disease, international consensus recommended considering CE only if ileocolonoscopy is contraindicated or unsuccessful. In the case of IBDU, studies have shown a significant proportion of patients reclassified with Crohn’s disease. In this setting, CE could have a role determining small bowel involvement. The role of CE in ulcerative colitis is limited. Some authors advocate CE before colectomy for refractory cases in order to exclude Crohn’s disease. In summary, CE offers a new horizon in inflammatory bowel disease, and a better knowledge of mucosal abnormalities that could offer a paradigm shift: changing from symptom-based disease activity estimation to direct mucosal healing monitoring. Nevertheless, randomized controlled studies are still needed to provide stronger evidence in this setting.

Keywords: Wireless capsule endoscopy; Crohn’s disease; Ulcerative colitis; Inflammatory bowel disease