Capsule endoscopy in clinical routine in patients with suspected disease of the small intestine: a 2-year prospective...

Capsule endoscopy is a promising method for examining the small intestine. The study was performed to evaluate the use of capsule endoscopy in clinical routine in patients with suspected disease of the small intestine.

Consecutive patients with clinically suspected disease of the small intestine referred for capsule endoscopy between 1 January 2003 and 31 December 2004 were included in the study. All patients had previously completed a conventional diagnostic work-up with upper and lower endoscopy as well as abdominal CT scan or small-bowel enteroclysis.

A total of 167 patients were referred during the time period and 195 procedures were performed. Seventeen (8.7%) of the procedures were unsuccessful, with no visualization of the small bowel. In the remaining procedures the caecum was reached in 83%. The reason for referral was gastrointestinal bleeding (30%), iron-deficiency anaemia (25%), abdominal pain (15%), diarrhoea (13%) and Crohn's disease (12%). Pathology was found in 27% of the patients, with the highest diagnostic yield in patients referred for Crohn's disease (60%) and the lowest yield (4%) in patients referred for abdominal pain. There were no complications, with the exception of one patient referred for Crohn's disease who had transient abdominal pain during the procedure.

Capsule endoscopy is a safe and well-tolerated procedure. In unselected patients with clinically suspected disease of the small intestine, the procedure gives additional information to conventional diagnostic procedures in 27% of patients. Incomplete examination of the small intestine was frequent in our group of patients.