Video Capsule Endoscopy and Crohn’s Disease

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A prospective, multi-center study was carried out to evaluate small-bowel capsule endoscopy (CE) for the longitudinal assessment of mucosal inflammation in subjects with Crohn’s disease(CD). Clinical evaluation was carried out with ileocolonoscopy and CE at baseline at 6 month followup. Small bowel patency was confirmedbefore CD at both time points. The Simple Endoscopic Score for CD (SES-C), was used for colonoscopy, and the Lewis Score and the CECD Endoscopic Index of Severity (CECDEIS) were used for CE.

Clinical scoring indices included the physician global assessment (PGA), CD activity index (CDAI), and Harbey-Bradshaw Index (HBI). Laboratory markers included CRP, fecal calprotectin, and ESR collected at baseline and followup. Correlation between endoscopic scores and clinical parameters were measured using Spearman test.

A total of 74 subjects were enrolled; 53 (72%) completed endoscopic procedures at baseline and 6-month followup. The SES-CD ileocolonoscopy score correlated with the Lewis Score and CECDEIS capsule score. None of the three endoscopic scores correlated with PGA, CDAI, HBI, CRP, ESR orfecal calprotectin. A total of 85% of subjects had proximal small bowel inflammation identified onCE. There were no CE-related adverse events.

It was concluded that there was high correlation between CE and ileocolonoscopy scores for the assessment of mucosal disease activity over time; however, there were no correlations between endoscopic scores and clinical parameters. The use of CE for the assessment of small-bowel CD is feasible and valid.

Melmed, G., Dubinsky, M., Rubin, D., et al. “Utility of Video Capsule Endoscopy for Longitudinal Monitoring of Crohn’s Disease Activity in the Small Bowel: A Prospective Study. Gastrointestinal Endoscopy; Vol. 88, No. 6, 2018, pp. 947-955.

Murray H. Cohen, DO, “From the Literature” Editor, is on the Editorial Board of Practical Gastroenterology.