Capsule endoscopy and panendoscopy: A journey to the future of gastrointestinal endoscopy

Table 1 Technical details of double-headed capsules currently available to perform pan-intestinal capsule endoscopy

	PillCamTM COLON2 (Medtronic, Given Imaging Inc.)	PillCamTM Crohn’s (Medtronic, Given Imaging Inc.)	OMOMTM CC (Jinshan)
Dimensions (mm)	11.6 × 32.3	11.6 × 32.3	11.6 × 31.5
Optical domes	2	2	2
Resolution (pixels)	256 × 256	256 × 256	360 × 360
Lens angle (degrees per side)	172	168	172
Frame rate (frames per second)	4-35	4-35	4-35
Sleep mode	Yes	No	No
Battery life (h)	≥ 10	≥ 10	≥ 10

Table 2 Standard bowel preparation for pan-intestinal capsule endoscopy

	Bowel preparation protocol
Day 2	Low-fibre diet
Day 1	Clear-liquids diet
	7:00 – 9:00 PM 2 L of PEG
Examination day	06:30 – 7:30 AM 1 L of PEG
	08:15 AM 10 mg metoclopramide p.o.
	08:30 AM 100-200 mg simethicone in water for capsule ingestion
	09:30 AM check real time viewer. Additional 10 mg metoclopramide p.o. if capsule still in stomach
	First alert (capsule detected in SB) NaP 30 mL + 1 L water
	Second alert (3h after 1st booster) NaP 15 mL + 0.5 L water
	Third alert (2h after 2nd booster) 10 mg bisacodyl rectal suppository

PEG: Polyethylene glycol; p.o.: Per os; NaP: Sodium phosphate; SB: Small bowel.

Table 3 Indications and contraindications for pan-intestinal capsule endoscopy

Indications	Contraindications
CD	(1) Known or suspected intestinal strictures and/or fistulae (if patency not proven based on cross sectional imaging and/or patency capsule assessment[14]); (2) Magnetic resonance imaging examination scheduled for same-day or following days (requires prior confirmation of capsule excretion); and (3) Special conditions and relative contraindications: pregnancy; children under 8 yr of age; swallowing disorders; gastric surgery; implanted cardiac electric devices: Pacemakers, defibrillators, ventricular assist devices, telemetry; allergy or contraindications to any of the drugs or products used in the protocol; patients unable to walk for short periods and/or with neurological and/or psychiatric condition potentially favouring protocol deviations
Inflammatory-type (non-stricturing, non-penetrating), extensive (affecting small bowel and colon)
Scheduled monitoring to evaluate mucosal healing in response to treatment (to justify and guide treatment change)
Evaluate disease distribution and severity: stratify patients to low vs high risk (prognosis); asymptomatic CD patients with abnormal analysis; exclude active CD or investigation of symptoms unrelated to disease activity
Establish diagnosis in patients with IBD-U, suspected CD or atypical ulcerative colitis
Gastrointestinal bleeding
Suspected mid-lower intestinal bleeding (overt or occult)

CD: Crohn’s disease; IBD-U: Inflammatory bowel disease - type unclassified.