Capsule endoscopy: Future horizons

Capsule endoscopy (CE) was launched at the beginning of this millennium and has since become a well established methodology for evaluating the entire small bowel for manifold pathologies. CE far exceeded early expectations by providing a tool for establishing the correct diagnosis for elusive gastrointestinal (GI) conditions such as obscure GI bleeding, Crohn's disease, polyposis syndrome and others. Contemporary CE, like radiology, gives results that can only be read, unlike conventional endoscopic procedures which enable concomitant biopsy when indicated. This is one of the major limitations of the technique. The ideal CE should improve the quality of the image and have a faster frame rate than the currently available one. There should be a therapeutic capsule capable of performing a biopsy, aspirating fluid, delivering drugs as well as measuring the motility of the small bowel wall. Another major leap forward would be the capability of remote control of the capsule's movement in order to navigate it to reach designated anatomical areas for carrying out a variety of therapeutic options. Technology for improving the capability of the future generation capsule is almost within grasp and it would not be surprising to witness the realization of these giant steps within the coming decade.