![]() If mucosal healing remains a primary endpoint of UC management, patients will need to undergo periodic endoscopic surveillance in addition to other noninvasive tests such as fecal calprotectin. More research needs to be performed before we can determine the true diagnostic accuracy of this test in patients with this disease. The precise role of CCE in UC remains to be defined. What more do we need to learn about using this tool in managing UC? Further studies are needed to evaluate this role for CCE. In addition, CCE was both better tolerated and preferred by patients over colonoscopy. In our article we share available data from the literature showing that CCE has a fairly high degree of specificity and sensitivity, and substantial agreement with colonoscopy findings using the Mayo endoscopic score and the Ulcerative Colitis Endoscopic Index of Severity. Colon capsule endoscopy (CCE) has potential as a noninvasive tool for diagnosis and monitoring of UC. Ileocolonoscopy is currently the diagnostic procedure of choice in patients with UC. Small bowel CE is useful in ruling out small bowel CD in patients with IBD when there is not a clear diagnosis of UC. Therefore, the published evidence demonstrating the use of CCE in individuals with UC is still fairly limited. While small bowel CE has been fairly well studied in CD, colon capsule endoscopy (CCE) for ulcerative colitis (UC) has not been as well studied. What role can CE play in diagnosing and managing UC? Pan-enteric capsule endoscopy (PCE), in particular, might have a potential role in the future for assessment of patients with small bowel and colonic CD. But CE may have a role in monitoring select patients with nonstricturing small bowel CD to confirm mucosal healing. Because CE can detect mucosal inflammation that might be missed by less sensitive modalities, it facilitates monitoring of disease activity more accurately, and it can thus guide management.Ĭross-sectional studies such as computerized tomography (CT) or magnetic resonance (MR) enterography are also helpful to evaluate response to therapy. Mucosal healing in the small bowel after initiation of medical management is predictive of reduced activity in the future and overall better patient outcomes. Can you explain CE's role in assessing mucosal healing and treat-to-target progress in patients with established CD?Ĭlinical symptoms do not consistently correlate with disease activity, and therefore endoscopic visualization of the mucosa is the most objective way to evaluate and document response to medical therapy in patients with CD. In patients with established CD, CE can help determine extent of disease, assess its severity in the small bowel and assist in monitoring response to therapy. However, small bowel CE can be useful when ileocolonoscopy is negative, especially if small bowel cross-sectional imaging is also negative, and the index of suspicion for CD remains high. In most patients with suspected CD, ileocolonoscopy is still the most appropriate first evaluation. Small bowel CE provides us with a well-tolerated, less invasive way to visualize the entire length of the small bowel in patients with Crohn's disease (CD). Changes consistent with NSAID enteropathyĬapsule endoscopy images of the small bowel show changes consistent with NSAID enteropathy.
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