CAPSULE ENDOSCOPIC SCORING FOR CROHN’S DISEASE IN CLINICAL PRACTICE

Abstract

Crohnʼs disease(CD) is a chronic progressive, destructive inflammatory disease characterized by repeated inflammation and intestinal damage, mainly in the small and large intestines. Assessment and quantification of mucosal inflammation by small bowel capsule endoscopy are important because small bowel lesions are often poorly reflected in clinical symptoms and biomarkers. Lewis Score and the Capsule Endoscopy Crohnʼs Disease Activity Index are commonly used small bowel capsule endoscopy scores for CD. Although extensive evidence is available for these scores, it is important to note that judging by scores alone may lead to a misdiagnosis of the pathophysiology of CD, which comprises inflammation and organic changes such as stenosis. The information reported should include patency capsule evaluation results, history of intestinal surgery, and intestinal transit time. In addition, postoperative anastomotic ulcers and stenosis sites that are difficult to determine based on the score and characteristic gastric lesions such as those with a bamboo-joint appearance and duodenal notch-like depression should be noted without fail.