Current role of capsule endoscopy in Crohn’s disease

Table 1 Capsule endoscopy Crohn’s disease activity index

Inflammation score

0: None

1: Mild to moderate edema/hyperemia/denudation

2: Severe edema/hyperemia/denudation

3: Bleeding, exudate, aphtha, erosion, small ulcer (< 0.5 cm)

4: Moderate ulcer (0.5-2 cm), pseudopolyp

5: Large ulcer (> 2 cm)

Disease extension score

0: No disease - normal exploration

1: Focal disease (single segment involvement)

2: Patchy disease (2-3 segments involved)

3: Diffuse disease (> 3 segments involved)

Stricturing score

0: None

1: Single - passed

2: Multiple - passed

3: Obstructing (not passed)

Segmentary score (proximal or distal): (A × B) + C

Total score: Proximal [(A × B) + C)] + distal [(A × B) + C]

Table 2 Lewis score for mucosal inflammatory changes

Lesions in the proximal, mid, and distal small bowel thirds

Villous appearance

0: Normal

1: Edema

8: Short segment

12: Long segment; 20: The whole third

1: Single; 14: Patchy

Ulcers

0: None; 3: One; 5: Few; 10: Multiple

5: Short segment; 10: Long segment; 15: The whole third

9: 1⁄4; 12: 1⁄4-1⁄2; 18: > 1⁄2

Strictures

0: None; 14: One

2: Non ulcerated; 24: Ulcerated

7: No retention; 10: Capsule retention

Score calculation: Stricture score is added to the sum total for highest scoring villous edema and segment ulcers