The utility of capsule endoscopy in the diagnosis of Crohn's disease based on patient's symptoms.
OBJECTIVE
Video capsule endoscopy (VCE) enables visualization of the entire small bowel and can identify lesions that may go undetected by conventional endoscopy and radiography. In this study, we assessed whether patient's selection based on symptoms may increase the yield of VCE in the diagnosis of Crohn's disease (CD).


METHODS
Findings of 125 consecutive patients referred for VCE in whom CD may be suspected, were analyzed. Indications for VCE included iron-deficiency anemia, abdominal pain, diarrhea, or a combination of symptoms. Capsule endoscopy (CE) results were defined positive if 4 or more obvious clear ulcers, erosions, or a region with clear exudate and mucosal hyperemia and edema were identified.


RESULTS
One hundred twelve patients were included in the final analysis. Mean age of patients was 44+/-22 years and median follow-up 36+/-15 months. Findings on CE were considered compatible with a diagnosis of CD in 7 patients (6%). In general, CE yielded a diagnosis of CD in a very small portion of the patients (0% to 4%), except in patients undergoing the test for a combination of abdominal pain and diarrhea. In this group, findings suggestive of inflammatory bowel disease were encountered in one-third of the patients (P=0.002).


CONCLUSIONS
The greatest yield of CE in diagnosing CD is achieved in young patients who present with symptoms of abdominal pain plus diarrhea.
Fidder
Herma H
HH
Department of Gastroenterology, Sackler School of Medicine, Chaim Sheba Medical Center, Tel Aviv University, Israel.
Nadler
Moshe
M
Lahat
Adi
A
Lahav
Maor
M
Bardan
Eitan
E
Avidan
Benjamin
B
Bar-Meir
Simon
S
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D053704:Capsule Endoscopy / Q000379:methods*; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis*; D003967:Diarrhea / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D018709:Statistics, Nonparametric