Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease

Table 1 Advantages and disadvantages of wireless capsule endoscopy

Advantages

Non-invasive well-tolerated method

Allows direct visualization of distal and proximal parts of the small bowel (SBCE) and large bowel mucosa(CCE)

Disadvantages

High cost compared to other modalities

Inability of tissue sampling

Significant incompletion rate (15%-30%)

Risk of capsule retention (2.6%)

Risk of aspiration

SBCE: Small bowel capsule endoscopy; CCE: Colon capsule endoscopy.

Table 2 Key studies describing the role of wireless capsule endoscopy on the assessment of mucosal healing in Crohn’s disease patients under treatment

	Ref.	Treatment	Indication	Patients (n)	Conclusion
CD	Niv et al[2]	Yes	SB mucosa evaluation of known CD patients	19	Musocal findings are independent from clinical and laboratory parameters
CD	Hall et al[1]	Yes	SB mucosal healing and deep remission rates assessment on 12 wk of treatment of known symptomatic CD patients	43	Symptomatic and biochemical response to treatment is not mirrored by mucosal healing
CD	Hall et al[33]	Yes	SB mucosal healing and deep remission rates assessment on 52 wk of treatment of known symptomatic CD patients	43	Symptomatic and biochemical response to treatment appears to be mirrored by endoscopic remission in 42% of individuals
CD	Efthymiou et al[3]	Yes	SB mucosal healing assessment of known symptomatic CD patients	40	Clinical response does not correlate closely with mucosal healing in patients with CD of the small bowel
CD	Tsibouris et al[32]	Yes	Assessment of detection rate of small bowel ulcerative lesions and completion rate in CD patients in acute phase and remission	102	SB aphthous ulcers are present a month after entering clinical remission

CD: Crohn’s disease; SB: Small bowel; CRP: C-reactive protein.

Table 3 Key studies on the role of wireless capsule endoscopy on postoperative Crohn’s disease recurrence

Patientgroup	Ref.	No. of patients	WCEfindings/(n)	Ileocolonoscopyfindings/(n)
CD	Bourreille et al[55]	32	21/(32)	19/(32)
CD	Pons Beltrán et al[56]	24	15/(22)	6/(19)
CD	Biancone et al[54]	22	16/(17)	21/(22)
CD	Kono et al[57]	19	14/(18)	NA

CD: Crohn’s disease; WCE: Wireless capsule endoscopy; WCE findings: Number of patients with findings on WCE; WCE (n): Total number of patients who had undergone WCE; Ileocolonoscopy findings: Number of patients with findings on ileocolonoscopy; Ileocolonoscopy (n): Total number of patients who had undergone ileocolonoscopy; NA: Not available.

Table 4 Key studies on the role of wireless capsule endoscopy on pouchitis patients

Patientgroup	Ref.	No. of patients	WCE findings/(n)	CD reclassification
UC (IPAA)	Calabrese et al[61]	16	15/(15)	None
UC (IPAA)	Mehdizadeh et al[62]	21	7/(21)	7
UC (IPAA)	Long et al[35]	23	13/(23)	3

UC: Ulcerative colitis; IPAA: Ileal pouch-anal anastomosis; WCE findings: Number of patients with findings on WCE; WCE (n): Total number of patients who had undergone WCE; CD: Crohn’s disease; WCE: Wireless capsule endoscopy.

Table 5 Key studies evaluating the role of wireless capsule endoscopy on disease reclassification

Patientgroup	Ref.	No. of patients	SB findings of inflammation	Reclassified to CD
UC/IC	Gralnek et al[68]	4	2	2
UC	Higurashi et al[64]	23	13	None
UC/IC	Cohen et al[67]	7	5	5
UC/IBDU	Mehdizadeh et al[62]	120	19	NA
IBDU	Maunoury et al[66]	30	5	5
UC/IC	Mow et al[65]	21	12	5

UC: Ulcerative colitis; IC: Indeterminate colitis; IBDU: Inflammatory bowel disease unclassified; SB: Small bowel; CD: Crohn’s disease; NA: Not available.