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Matthew A. Ciorba, Chandra Prakash, Wireless Capsule Endoscopy in the Diagnosis of Small Bowel Crohn's Disease, Inflammatory Bowel Diseases, Volume 9, Issue 4, 1 July 2003, Page 276, https://doi.org/10.1097/00054725-200307000-00010
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Diagnosing small bowel Crohn's disease with wireless capsule endoscopy . Fireman Z, Mahajna E, Briode E, Shapiro M, Fich L, Sternberg A, Kopelman Y, Scapa E. Gut 2003;52:390–2.
Wireless capsule endoscopy (WCE) is a novel diagnostic modality that allows noninvasive visualization of the small bowel mucosa and has revolutionized evaluation of obscure gastrointestinal bleeding (Nature 2000;405:417–8, Gastrointest Endosc 2002;56:349–53). The patient swallows an 11 × 26-mm capsule that transmits 2 video images per second to a receiver worn at the belt. Over the duration of an 8-hour study, more than 50,000 images are captured. Dedicated software allows subsequent evaluation of the images at rates of up to 25 images per second (Nature 2000;405:417–8).
Since small bowel mucosa can be visually examined with WCE, diagnosis of small bowel mucosal lesions can be facilitated by this exciting new technique. The article by Fireman et al. evaluates its potential for diagnosing Crohn's disease of the small bowel (Gut 2003;52:390–2). A nationwide call for patients in Israel yielded 17 patients with symptoms that could be consistent with small bowel inflammation (abdominal pain, iron deficiency anemia, diarrhea, weight loss, fever, and elevated ESR), with a mean duration of symptoms of 6.3 ± 2.2 years. Small bowel radiography, colonoscopy, and upper endoscopy results were negative within the previous 6 months in all patients; however, only 6 patients had ileoscopy performed during colonoscopy; the results were negative in all instances. WCE demonstrated mucosal erosions, ulcerations, and strictures, predominantly in the distal small bowel in 12 patients, independently confirmed by two examiners. The authors contend that these mucosal lesions were consistent with Crohn's disease, and 10 patients demonstrated good clinical improvement with treatment that included 5-ASA compounds and short-term steroid treatment (Gut 2003;52:390–2).
