Capsule endoscopy (CE) represents a significant advance in the investigation of small bowel diseases. Twothirds
of Crohn’s disease (CD) patients have small bowel involvement at diagnosis. Study of small intestine mucosa by
CE may have a strong impact on CD management in a near future. CE may be superior to small bowel cross-sectional imaging
for detection of mucosal lesions consistent with CD and a normal CE has a high negative predictive value for active
small bowel CD. A GI imaging study should generally precede CE to rule out complications such as fistulas and strictures.
In established CD, CE may be useful in patients with unexplained symptoms when other investigations are inconclusive,
if this will alter management. The low specificity of CE is its main drawback. Furthermore, there are no validated
CD diagnosis criteria for CE and no severity indexes have been independently validated. The role of CE in evaluating mucosal
healing and postoperative recurrence will require additional investigation.
Keywords: Capsule endoscopy, Crohn’s disease, small bowel diseases, cross-sectional imaging, mucosal lesions, GI imaging, mucosal
healing, detection, gastrointestinal (GI), inflammatory bowel disease unclassified (IBDU).
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