Diagnostic Challenges and Management of Crohn's Disease: The Value of Capsule Endoscopy

Crohn's disease (CD) can be difficult to diagnose, particularly in its early stages when symptoms lack chronicity. This report describes a male patient with persistent right lower quadrant (RLQ) pain and weight loss despite an appendectomy. Despite normal biopsies and imaging, symptoms continued, prompting further evaluation with capsule endoscopy (CE), which revealed distal small bowel inflammation supporting the diagnosis of CD. Treatment with mesalamine and a specific carbohydrate diet (SCD) led to symptom resolution. However, after discontinuing treatment, the patient developed disease progression and complications. This case underscores the limitations of standard diagnostics and the value of CE in detecting early small bowel CD and highlights the importance of sustained maintenance therapy to prevent progression.