title: Video capsule endoscopy in celiac disease: current clinical practice.
abstract: OBJECTIVE
  A complete examination of the small intestine is possible by video capsule endoscopy (VCE). The aim of this study was to evaluate current indications for performing VCE in celiac disease.
  
  
  METHODS
  In all 84 celiac disease patients on a gluten-free diet who had undergone VCE were enrolled at five centers in Europe. The indications, findings and clinical impact of VCE were recorded by a structured questionnaire. VCE was also carried out in 34 consecutive patients with untreated celiac disease (controls) in another center.
  
  
  RESULTS
  Out of the 84 patients, 34 had overt symptoms and small intestinal histology compatible with refractory celiac disease. VCE was normal in 9 patients, and 7 had only proximal and one distal atrophy, 14 had intestinal ulcer and 2 an intestinal stricture. VCE was used in the adjustment of immunosuppressive treatment in 9 patients. In the remaining 50 patients, a VCE was performed because of less severe symptoms, 31 of which had an earlier histological recovery. The VCE showed proximal small bowel atrophy in 21 and distal atrophy in 3 patients, and 3 ulcers were seen. In this group the patients received mainly advice with a view to achieving better dietary compliance. Of the 34 newly detected celiac patients, 4 were normal, 27 proximal and 3 had distal small intestinal atrophy in the VCE.
  
  
  CONCLUSIONS
  VCE has a definite impact on the management of refractory sprue. In the remaining patients with established celiac disease, the procedure plays a more limited role.
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Medical School, University of Tampere, Tampere, Finland. Pekka.Collin@uta.fi
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Emanuele
authors.initials: E
authors.lastname: Rondonotti
authors.forename: Knut Ea
authors.initials: KE
authors.lastname: Lundin
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spada
authors.forename: Martin
authors.initials: M
authors.lastname: Keuchel
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Roberto
authors.initials: R
authors.lastname: DE Franchis
authors.forename: Maarten Ajm
authors.initials: MA
authors.lastname: Jacobs
authors.forename: Federica
authors.initials: F
authors.lastname: Villa
authors.forename: Chris Jj
authors.initials: CJ
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D053704:Capsule Endoscopy; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology*; D055050:Diet, Gluten-Free; D005260:Female; D005762:Gastroenterology / Q000639:trends; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008871:Microvilli / Q000473:pathology; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D055815:Young Adult