Wireless Capsule Endoscopy Helps Diagnose Crohn's Disease

Laurie Barclay, MD

March 17, 2003

March 17, 2003 — Wireless capsule endoscopy is effective in diagnosing Crohn's disease (CD) in patients suspected of having the disease but who had normal imaging studies, according to the results of a small study published in the March issue of Gut.

"The current visualization and imaging methods available to the gastroenterologist in diagnosing small bowel diseases and disorders are unsatisfactory," write Z. Fireman, from Hillel Yaffe Medical Center in Hadera, Israel, and colleagues. "The alternative solution should be relatively comfortable for the patient, easy to use by the gastroenterologist, relatively inexpensive, and one that will provide a reasonable level of visual imaging for the detection of small bowel abnormalities. The Given Diagnostic Imaging System (M2A Capsule) is a new modality designed to accommodate these requirements."

The M2A capsule contains a miniature video camera, a light source, batteries, and a radio transmitter, allowing images to be captured from the entire gastrointestinal tract and stored in a portable recorder for up to eight hours.

Of 17 patients with suspected CD, eight were men, nine had iron deficiency anemia, eight had abdominal pain, seven had diarrhea, and three had weight loss. Small bowel x-ray and endoscopy of the upper and lower gastrointestinal tract were normal. Mean age was 40 ± 15 years, and mean duration of symptoms before diagnosis was 6.3 ± 2.2 years.

Each subject swallowed an M2A capsule and excreted it naturally in the bowel movement the next day. Recording time was approximately eight hours. Of the 17 subjects, the M2A capsule allowed diagnosis of CD of the small bowel in 12 (70.6%).

Study limitations included short follow-up for patients receiving medications and failure to diagnose CD in two cases, related to decreased small bowel motility slowing the movement of the capsule and not allowing imaging of the entire small bowel in the limited time provided by the battery.

"To date, over 8,000 patients have undergone wireless capsule endoscopy worldwide," the authors write. "Our patients had long intervals from the onset of disease until diagnosis: the wireless capsule might have been able to provide a correct diagnosis during the early stages of disease as well as in cases of less severe forms. We propose the wireless capsule as being an effective modality for diagnosing patients with suspected CD."

Two of the study authors are members of the medical advisory board of Given Imaging.

Gut. 2003;52:390-392

Reviewed by Gary D. Vogin, MD

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