THE ROLE OF CAPSULE ENDOSCOPY IN THE MANAGEMENT OF CROHN’S DISEASE

Abstract

The entire small bowel can be visualized non-invasively by capsule endoscopy (CE). Therefore, CE is considered a good tool to evaluate Crohnʼs disease (CD) lesions in the entire small intestine. In contrast, the investigation is associated with a potential risk of capsule retention due to small bowel stenosis; therefore, the appropriate modality should be selected based on the clinical background and patency of the gastrointestinal tract.

The applications of CE in clinical practice include (1) initial diagnosis of CD and differentiation from other inflammatory diseases, (2) identifying the small intestinal lesions of CD and their distribution, and (3) evaluation of the therapeutic effect and endoscopic monitoring of patients in clinical remission. CD is characterized by conspicuous erosions and small ulcers from the jejunum to the ileum. CE has the highest detection sensitivity of CD in the small intestine compared to other modalities. CE should be performed 6 months after the start of treatment to determine the therapeutic effect. In the event of low endoscopic activity or in cases of remission, laboratory data should be assessed regularly and CE should be performed within 2 years. Diagnosis and monitoring with the appropriate modality, including CE, can ensure long-term maintenance of clinical remission and avoidance of surgery in patients with CD.