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World J Gastrointest Endosc. Jun 10, 2015; 7(6): 643-651
Published online Jun 10, 2015. doi: 10.4253/wjge.v7.i6.643
Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease
Ioannis V Mitselos, Dimitrios K Christodoulou, Konstantinos H Katsanos, Epameinondas V Tsianos
Ioannis V Mitselos, Dimitrios K Christodoulou, Konstantinos H Katsanos, Epameinondas V Tsianos, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dimitrios K Christodoulou, MD, PhD, Associate Professor of Gastroenterology, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, PO Box 1186, 45110 Ioannina, Greece. dchristo@uoi.gr
Telephone: +30-26-51099618 Fax: +30-26-51007883
Received: October 27, 2014
Peer-review started: October 28, 2014
First decision: November 27, 2014
Revised: January 15, 2015
Accepted: February 9, 2015
Article in press: February 11, 2015
Published online: June 10, 2015
Abstract

The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure’s inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn’s disease patients who have undergone ileocolonic resection for the treatment of Crohn’s disease complications, and in patients’ management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis.

Keywords: Small bowel capsule endoscopy, Colon capsule endoscopy, Crohn’s disease, Ulcerative colitis, Indeterminate colitis, Postoperative, Ileal pouch-anal anastomosis, Refractory pouchitis

Core tip: Wireless capsule endoscopy is a valuable diagnostic tool for the evaluation of lesions located on the small intestine and large bowel mucosa since the recent introduction of colon capsule endoscopy. It plays an important role in the early recognition of recurrence on postsurgical Crohn’s disease patients, offers valuable information on the evaluation of intestinal disease, and aids significantly in patient management, treatment tailoring and disease reclassification in patients with a previous diagnosis of ulcerative or indeterminate colitis. Patency capsule maximizes safety and is advocated in suspected small or large bowel stenosis.