Endoscopic tools for the diagnosis and evaluation of celiac disease

Abstract

Celiac disease (CD) is an autoimmune disease of the small bowel induced by ingestion of wheat, rye and barley. Current guidelines indicate histological analysis on at least four duodenal biopsies as the only way to diagnose CD. These indications are based on the conception of the inability of standard endoscopy to make diagnosis of CD and/or to drive biopsy sampling. Over the last years, technology development of endoscopic devices has greatly ameliorated the accuracy of macroscopic evaluation of duodenal villous pattern, increasing the diagnostic power of endoscopy of CD. The aim of this paper is to review the new endoscopic tools and procedures proved to be useful in the diagnosis of CD, such as chromoendoscopy, Fujinon Intelligent Chromo Endoscopy, Narrow Band Imaging, Optical Coherence Tomography, Water-Immersion Technique, confocal laser endomicroscopy, high-resolution magnification endoscopy, capsule endoscopy and I-Scan technology.

Keywords: Celiac disease; Malabsorption syndrome; Duodenum; Diagnostic techniques and procedures; Endoscopy; Chromoendoscopy; Fujinon intelligent chromo endoscopy; Narrow band imaging; Optical coherence tomography; Water-immersion technique; Confocal laser endomicroscopy; High-resolution magnification endoscopy; Capsule endoscopy; I-scan technology

Core tip: Celiac disease (CD) is an autoimmune disorder induced, in genetically predisposed people, by the ingestion of proteins rich in proline and glutamine. The aim of this review is to focus on the new endoscopic tools and techniques developed over the last years which can be useful in the diagnosis and the follow-up of CD.