title: Effectiveness and safety of capsule endoscopy in the diagnosis of small bowel diseases.
abstract: OBJECTIVE
  To assess the effectiveness, safety, and clinical use of capsule endoscopy (CE) in the diagnosis of small bowel diseases.
  
  
  METHODS
  Systematic review carried out in the main electronic databases, including MEDLINE, EMBASE, and COCHRANE. Papers were selected independently by the 2 researchers and the quality was determined using a purpose-designed scale.
  
  
  RESULTS
  A total of 9 systematic reviews and 28 original papers were included [11 assessed obscure gastrointestinal bleeding, 9 Crohn's disease (CD), and 4 hereditary polyposis syndromes]. The diagnostic yield of CE for the diagnosis of obscure gastrointestinal bleeding ranged from 39% to 77%. The diagnostic yield of push enteroscopy was lower than 40% in all but 1 study. CE detected suggestive findings in 19% to 71% of patients with suspected CD, whereas radiologic techniques did so in only 0% to 37% of the cases. In patients with suspected recurrence, detection with these techniques was 58% to 81% and 19% to 67%, respectively. Endoscopic capsule detected a greater number of polyps in patients with polyposis syndromes but other techniques allowed for better localization.
  
  
  CONCLUSIONS
  Although CE occupies a preferential place in the diagnosis of gastrointestinal bleeding and CD; there is insufficient evidence to establish whether it could be used as a first line diagnostic test. The evidence is insufficient to ascertain this technique's usefulness in small bowel disorders other than obscure bleeding or CD.
authors.affiliation: Galician Agency for Health Technology Assessment, Galician Health Authority, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Leonor
authors.initials: L
authors.lastname: Varela Lema
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruano-Ravina
mesh_terms: D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D004869:Equipment Safety; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D015203:Reproducibility of Results