The diagnostic value of video capsule endoscopy.
OBJECTIVE
Video capsule endoscopy (VCE) offers the best means of studying small bowel, but is expensive. We investigated how physicians appraise the value of VCE.


METHODS
A questionnaire was sent to remitting physicians comprising questions on the value of VCE in altogether 189 adults. The follow-up time was at least one year. The patient history was also scrutinized in case records.


RESULTS
The most common indications for VCE were anaemia (n=100) or gastrointestinal bleeding (n=21) (60%), suspicion of Crohn's disease (21%), abdominal pain (9%) and coeliac disease (6%). The diagnostic value of VCE was rated best in patients suffering from anaemia or bleeding, being decisive or beneficial in 33% (OR 2.3, CI=1.1-4.8 compared to all series) and helpful in exclusion in an additional 36%. In Crohn's disease, VCE was helpful in the exclusion of intestinal lesions in 50% of cases; in coeliac disease the corresponding percentage was 42%. When abdominal pain was the only indication for VCE, the examination was beneficial in one patient only.


CONCLUSIONS
The diagnostic value of VCE was evident in patients with anaemia or gastrointestinal bleeding. The procedure was deemed to be helpful in exclusion also in Crohn's disease and in coeliac disease. Abdominal pain was a rare indication, and the diagnostic yield limited.
Niemenmaa
Heidi
H
Tampere University Hospital, Department of Gastroenterology and Alimentary Tract Surgery and University of Tampere, Tampere, Finland.
Mäkelä
Tuula
T
Jussila
Airi
A
Krekelä
Ilkka
I
Voutilainen
Markku
M
Björknäs
Hans
H
Hirvioja
Alpo
A
Kaukinen
Katri
K
Collin
Pekka
P
D015746:Abdominal Pain / Q000175:diagnosis; D000328:Adult; D000740:Anemia / Q000175:diagnosis; D001291:Attitude of Health Personnel; D053704:Capsule Endoscopy / Q000592:standards*; D002446:Celiac Disease / Q000175:diagnosis; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005762:Gastroenterology; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006801:Humans; D011364:Professional Practice; D012015:Reference Standards; D011795:Surveys and Questionnaires