Capsule endoscopy in pediatric inflammatory bowel disease

Abstract

Capsule endoscopy (CE) requiring neither radiation nor sedation is a minimally invasive tool to assist in the diagnosis of small bowel Crohn disease (SBCD) and in the clarification of indeterminate colitis. Numerous studies have demonstrated that CE's diagnostic yield is superior to radiographic modalities and that CE is often the perfect complement to ileocolonoscopy in order to evaluate the small intestine, particularly for proximal disease. The release of a Crohn capsule, which extends a single viewing to the entire colon, opens up the possibility that pan-enteric endoscopy can be used as a single procedure to effectively monitor disease progression and mucosal healing, and to direct a treat-to-target strategy. However, capsule retention is more common in known Crohn disease, requiring either a patency capsule or magnetic resonance enterography be performed to avoid complications. Additionally, optimal bowel cleansing and scoring systems continue to be sought.