Capsule endoscopy in the evaluation of inflammatory bowel disease

The video capsule endoscope is an ingestible and disposable video camera that transmits high quality images of the small bowel mucosa. Capsule endoscopy (CE) has the potential to facilitate the evaluation of Crohn’s disease (CD), providing access to bowel segments previously inaccessible by push enteroscopy and ileocolonoscopy. CE appears to be complementary to cross-sectional imaging techniques such as CT and MR enterography, which provide information regarding transmural inflammation and extraluminal disease. In comparison to advanced endoscopic techniques, CE has demonstrated comparable yields to double-balloon enteroscopy in CD patients. CE also has the ability to document mucosal healing in response to treatment in established CD, and has proven instrumental in further categorizing patients diagnosed with inflammatory bowel disease unspecified. As a non-invasive test, CE holds particular promise in the evaluation of pediatric inflammatory bowel disease. A colonic pill endoscope is under investigation in the evaluation of ulcerative colitis. Although the risk of capsule retention remains a concern in patients with stricturing disease, CE is considered safe in the vast majority of patients.