Role of wireless capsule endoscopy in inflammatory bowel disease

来源 :World Journal of Gastrointestinal Endoscopy | 被引量 : 0次 | 上传用户:chenanji
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Capsule endoscopy(CE) offers state-of-the-art imaging of the small bowel.In Crohn’s disease its clinical role is still uncertain.This report analyses the usefulness of CE in patients with suspected Cronh’s disease,in patients with established Crohn’s disease(when assessing severity,occult gastrointestinal bleeding and/or as a guide to therapy),in patients with inflammatory bowel disease unclassified(IBDU),and in individuals with ulcerative colitis.The first item in this group is the most important although there is no strong evidence to establish the position of CE in the diagnostic workup.In patients with established Crohn’s disease,recently developed activity scores are promising tools for an accurate assessment of severity.As a guide to therapy,CE should be focused on patients with unexplained symptoms when other investigations are inconclusive.In postoperative Crohn’s Disease,international consensus recommended considering CE only ifileocolonoscopy is contraindicated or unsuccessful.In the case of IBDU,studies have shown a significant proportion of patients reclassified with Crohn’s disease.In this setting,CE could have a role determining small bowel involvement.The role of CE in ulcerative colitis is limited.Some authors advocate CE before colectomy for refractory cases in order to exclude Crohn’s disease.In summary,CE offers a new horizon in inflammatory bowel disease,and a better knowledge of mucosal abnormalities that could offer a paradigm shift:changing from symptombased disease activity estimation to direct mucosal healing monitoring.Nevertheless,randomized controlled studies are still needed to provide stronger evidence in this setting. Capsule endoscopy (CE) offers state-of-the-art imaging of the small bowel. In Crohn’s disease its clinical role is still uncertain. This report analyzes the usefulness of CE in patients with suspected Cronh’s disease, in patients with established Crohn’s disease ( when assessing severity, occult gastrointestinal bleeding and / or as a guide to therapy), in patients with inflammatory bowel disease unclassified (IBDU), and in individuals with ulcerative colitis. first first in this group is the most important thinks there is no strong evidence to establish the position of CE in the diagnostic workup. patients with established Crohn’s disease, recently developed activity scores are promising tools for an accurate assessment of severity. As a guide to therapy, CE should be focused on patients with unexplained symptoms when other investigations are inconclusive. postoperative Crohn’s Disease, international consensus recommended considering CE only ifileocolonoscopy is contraindicated or unsuccessfu l.In the case of IBDU, studies have shown a significant proportion of patients reclassified with Crohn’s disease. This setting, CE could have a role determining small bowel involvement. role of CE in ulcerative colitis is limited. colectomy for refractory cases in order to exclude Crohn’s disease. In summary, CE offers a new horizon in inflammatory bowel disease, and a better knowledge of mucosal abnormalities that could offer a paradigm shift: changing from symptomased disease activity estimation to direct mucosal healing monitoring. Nevertheless, randomized controlled studies are still needed to provide stronger evidence in this setting.
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