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Capsule Endoscopy



A pillcam next to a paracetamol tablet.

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About Capsule Endoscopy (CE)

Capsule Endoscopy (CE) involves the patient swallowing a large pill containing a camera. They then carry equipment on a belt which recieves images from the camera as it passes through the digestive tract. The recordings continue for about 8 hours. The patient must monitor their bowel movements after the test in order to retrieve the pillcam.

Preparation for Capsule Endoscopy Procedure

In order to obtain clear images, the patient will be asked to prepare for the test, by fasting, taking laxatives, or a combination of both.

Advantages of Capsule Endoscopy

  • Good way of imaging the majority of the small intestine
  • Can succeed in diagnosing a patient when all other tests are negative

Disadvantages of Capsule Endoscopy

  • Expensive
  • Takes up a lot of doctor time viewing images
  • Risk of camera getting stuck, requiring surgery. For this reason pre-tests (such as swallowing a dissolvable pill, X-ray studies, or performing a small bowel follow through may be performed to check for potential problems
  • Not suitable for people with gastroparesis
  • Not recommended for Crohn's Disease patients with Stricturing Disease
  • While it is very sensitive (correctly identifies Crohn's Disease) this is offset by low specificity (identifies Crohn's Disease when it's not actually Crohn's Disease). Findings of Crohn's disease have been found in up to 20% of healthy patients, and up to 70% of patients on medications, especially NSAIDs.[2]

Capsule Endoscopy Versus other Tests

For detecting Crohn's Disease, one study found the following - the sensitivity and specificity was as follows, respectively: CTE = 82%/89%; ileocolonoscopy = 83%/100%; capsule endoscopy = 74%/53%; and small bowel follow-through = 65%/94%[2]

In another study comparing CTE with capsule endoscopy (pill cam), it was shown that capsule endoscopy identified Crohn's disease in 12 of 17 patients (71%), ileoscopy in 11 of 17 patients (65%), and CTE in 9 of 17 patients (53%)[2]

In a meta-analysis, it was shown that capsule endoscopy was diagnostic of Crohn's disease in 69% of patients whereas CTE was diagnostic in only 30%.[3]

Clinical Trials for PillCam Platform Capsule Endoscopy

Clinical Trial to investigate the effectiveness of the PillCam Platform with the PillCam Crohn's capsule by visualizing the small bowel and colon in patients with active Crohn's disease (CD) symptoms.
PillCam Clinical Trial for Crohn's Disease Patients

References


1. Akyuz F and Mungan Z. Diagnostic Capability of Capsule Endoscopy in Small Bowel Diseases. Gastroenterology Research. 2009;2(2): 81-85. http://www.gastrores.org/index.php/G...cle/view/84/78
[pos]2a[/pos][2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780209/
[pos]2a[/pos][2] http://www.ncbi.nlm.nih.gov/pubmed/16373764/
[pos]3a[/pos][3] http://www.ncbi.nlm.nih.gov/pubmed/16696781/

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