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Capsule endoscopy: past, present, and future

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Abstract

A capsule endoscope is a swallowable wireless miniature camera for getting images of the gastrointestinal (GI) mucosa. The initial capsule endoscope model was developed by Given Imaging and approved in Western countries in 2001. Before the introduction of capsule endoscopy (CE) and double-balloon endoscopy (DBE), there was no effective modality for the evaluation and management of patients with obscure GI bleeding. Obscure GI bleeding is defined as bleeding of unknown origin that persists or recurs after a negative initial or primary endoscopy (colonoscopy or upper endoscopy) result. The first capsule endoscope model, which is now regarded as a first-line tool for the detection of abnormalities of the small bowel, was the PillCam SB. It was approved in Japan in April 2007. The main indication for use of the PillCam SB is obscure GI bleeding. Almost the only complication of CE is capsule retention, which is the capsule remaining in the digestive tract for a minimum of 2 weeks. A retained capsule can be retrieved by DBE. There are some limitations of CE in that it cannot be used to obtain a biopsy specimen or for endoscopic treatment. However, the combination of a PillCam SB and DBE seems to be the best strategy for management of obscure GI bleeding. Recently, several new types of capsule endoscope have been developed, such as Olympus CE for the small bowel, PillCam ESO for investigation of esophageal diseases, and PillCam COLON for detection of colonic neoplasias. In the near future, CE is expected to have a positive impact on many aspects of GI disease evaluation and management.

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References

  1. Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature 2000;405:417.

    Article  PubMed  CAS  Google Scholar 

  2. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G. The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 2002;34:685–689.

    Article  PubMed  CAS  Google Scholar 

  3. Lewis BS, Swain P. Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study. Gastrointest Endosc 2002;56:349–353.

    Article  PubMed  Google Scholar 

  4. Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001;53:216–220.

    Article  PubMed  CAS  Google Scholar 

  5. Yamamoto H, Kita H. Enteroscopy. J Gastroenterol 2005;40:555–562.

    Article  PubMed  Google Scholar 

  6. Zuckerman GR, Prakash C, Askin MP, Lews BS. AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 2000;118:201–221.

    Article  PubMed  CAS  Google Scholar 

  7. Raju GS, Gerson L, Das A, Lewis B. American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 2007;133:1694–1696.

    Article  PubMed  Google Scholar 

  8. Appleyard M, Glukhovsky A, Swain P. Wireless-capsule diagnostic endoscopy for recurrent small-bowel bleeding. N Engl J Med 2001;344:232–233.

    Article  PubMed  CAS  Google Scholar 

  9. Lewis BS, Eisen G, Friedman S. Meta-analysis of capsule endoscopy versus alternative modalities in the diagnosis of small bowel pathologies. Gastrointest Endosc 2004;59:AB105.

    Google Scholar 

  10. Eliakim R, Yassin K, Shlomi I, Suissa A, Eisen GM. A novel diagnostic tool for detecting oesophageal pathology: the PillCam oesophageal video capsule. Aliment Pharmacol Ther 2004;20:1083–1089.

    Article  PubMed  CAS  Google Scholar 

  11. Nakamura T, Shirakawa K, Nakano M, Kanke K, Hiraishi H, Terano A. Present status and prospects of wireless capsule endoscopy (in Japanese). Nippon Shokakibyo Gakkai Zasshi 2004;101:970–975.

    PubMed  Google Scholar 

  12. Morita E, Tanaka T, Nakamura T, Terabe F, Hirata I, Katsu K, et al. Correlations between video capsule endoscopic findings and clinical activity in Crohn’s disease. Dig Endosc 2006;18:263–268.

    Article  Google Scholar 

  13. Gheorghe C, Iacob R, Bancila I. Olympus capsule endoscopy for small bowel examination. J Gastrointest Liver Dis 2007;16:309–313.

    Google Scholar 

  14. Cave DR. Reading wireless video capsule endoscopy. Gastrointest Endosc Clin N Am 2004;14:17–24.

    Article  PubMed  Google Scholar 

  15. Lewis B. Capsule endoscopy—transit abnormalities. Gastrointest Endosc Clin N Am 2004;16:221–228.

    Article  Google Scholar 

  16. Pennazio M. Capsule endoscopy: where are we after 6 years of clinical use? Dig Liver Dis 2006;38:867–868.

    Article  PubMed  CAS  Google Scholar 

  17. Tatar EL, Shen EH, Palance AL, Sun JH, Pitchumoni CS. Clinical utility of wireless capsule endoscopy: experience with 200 cases. J Clin Gastroenterol 2006;40:140–144.

    Article  PubMed  Google Scholar 

  18. Mishkin DS, Chuttani R, Croffie J, Disario J, Liu J, Shah R, Somogyi L, Tierney W, Song LM, Petersen BT. ASGE Technology Status Evaluation Report: wireless capsule endoscopy. Gastrointest Endosc 2006;63:539–545.

    Article  PubMed  Google Scholar 

  19. Triester SL, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, Heigh RI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005;100:2407–2418.

    Article  PubMed  Google Scholar 

  20. Marmo R, Rotondano G, Piscopo R, Bianco MA, Cipolletta L. Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases. Aliment Pharmacol Ther 2005;22:595–604.

    Article  PubMed  CAS  Google Scholar 

  21. Chen X, Ran ZH, Tong JL. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases. World J Gastroenterol 2007;13:4372–4378.

    PubMed  Google Scholar 

  22. Mergener K, Ponchon T, Gralnek I, Pennazio M, Gay G, Selby W, et al. Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/2007. Endoscopy 2007;39:895–909.

    Article  PubMed  CAS  Google Scholar 

  23. Yamagishi H, Fukui H, Shirakawa K, Oinuma T, Hiraishi H, Terano A, et al. Early diagnosis and successful treatment of small-intestinal carcinoid tumor: useful combination of capsule endoscopy and double-balloon endoscopy. Endoscopy 2007 Oct 24 [Epub ahead of print].

  24. Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 2004;126:643–653.

    Article  PubMed  Google Scholar 

  25. Barkin JS, Friendman S. Wireless endoscopy requiring surgical intervention: the world’s experience. Am J Gastroenterol 2002;97:S298.

    Article  Google Scholar 

  26. Bailey AA, Debinski HS, Appleyard MN, Remedios ML, Hooper JE, Walsh AJ, et al. Diagnosis and outcome of small bowel tumors found by capsule endoscopy: a three-center Australian experience. Am J Gastroenterol 2006;101:2237–2243.

    Article  PubMed  Google Scholar 

  27. Pasha SF, Sharma VK, Carey EJ, Shiff AD, Heigh RI, Gurudu SR, et al. Utility of video capsule endoscopy in the detection of small bowel tumor—a single centre experience of 1000 consecutive patients. International Conference on Capsule Endoscopy, 8–9 June 2007, Madrid. Program and Abstracts, p. 45.

  28. Rondonotti E, Villa F, Mulder CJ, Jacobs MA, de Franchis R. Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol 2007;13:6140–6149.

    Article  PubMed  Google Scholar 

  29. Hopper AD, Sidhu R, Hurlstone DP, McAlindon ME, Sanders DS. Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease? Dig Liver Dis 2007;39:140–145.

    Article  PubMed  CAS  Google Scholar 

  30. Rondonotti E, Spada C, Cave D, Pennazio M, Riccioni ME, De Vitis I, et al. Video capsule enteroscopy in the diagnosis of celiac disease: a multicenter study. Am J Gastroenterol 2007;102:1624–16231.

    Article  PubMed  Google Scholar 

  31. Goldstein JL, Eisen GM, Lewis B, Gralnek IM, Zlotnick S, Fort JG. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 2005;3:133–141.

    Article  PubMed  Google Scholar 

  32. Gomez BJ, Caunedo A, Redondo L, Esteban J, Saenz-Dana M, Blasco M, et al. Modification of pepsinogen I levels and their correlation with gastrointestinal injury after administration of dexibuprofen, ibuprofen or diclofenac: a randomized, open-label, controlled clinical trial. Int J Clin Pharmacol Ther 2006;44:154–162.

    PubMed  CAS  Google Scholar 

  33. Schulmann K, Hollerbach S, Kraus K, Willert J, Vogel T, Moslein G, et al. Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes. Am J Gastroenterol 2005;100:27–37.

    Article  PubMed  Google Scholar 

  34. Burke CA, Santisi J, Church J, Levinthal G. The utility of capsule endoscopy small bowel surveillance in patients with polyposis. Am J Gastroenterol 2005;100:1498–1502.

    Article  PubMed  Google Scholar 

  35. Brown G, Fraser C, Schofield G, Taylor S, Bartram C, Phillips R, et al. Video capsule endoscopy in Peutz-Jeghers syndrome: a blinded comparison with barium follow-through for detection of small-bowel polyps. Endoscopy 2006;38:385–390.

    Article  PubMed  CAS  Google Scholar 

  36. Maunoury V, Savoye G, Bourreille A, Bouhnik Y, Jarry M, Sacher-Huvelin S, et al. Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified). Inflamm Bowel Dis 2007;13:152–155.

    Article  PubMed  Google Scholar 

  37. Adler SN, Jacob H, Lijovetzky G, Mulder CJ, Zwiers A. Positive coeliac serology in irritable bowel syndrome patients with normal duodenal biopsies: video capsule endoscopy findings and HLADQ typing may affect clinical management. J Gastrointest Liver Dis 2006;15:221–225.

    Google Scholar 

  38. Pungpapong S, Stark ME, Cangemi JR. Protein-losing enteropathy from eosinophilic enteritis diagnosed by wireless capsule endoscopy and double-balloon enteroscopy. Gastrointest Endosc 2007;65:917–918.

    Article  PubMed  Google Scholar 

  39. Fritscher-Ravens A, Swain CP, von Herbay A. Refractory Whipple’s disease with anaemia: first lessons from capsule endoscopy. Endoscopy 2004;36:659–662.

    Article  PubMed  CAS  Google Scholar 

  40. de Franchis R, Rondonotti E, Abbiati C, Beccari G, Merighi A, Pinna A, et al. Capsule enteroscopy in small bowel transplantation. Dig Liver Dis 2003;35:728–731.

    Article  PubMed  Google Scholar 

  41. Silbermintz A, Sahdev I, Moy L, Vlachos A, Lipton J, Levine J. Capsule endoscopy as a diagnostic tool in the evaluation of graft-vs.-host disease. Pediatr Transplant 2006;10:252–254.

    Article  PubMed  Google Scholar 

  42. Neumann S, Schoppmeyer K, Lange T, Wiedmann M, Golsong J, Tannapfel A, et al. Wireless capsule endoscopy for diagnosis of acute intestinal graft-versus-host disease. Gastrointest Endosc 2007;65:403–409.

    Article  PubMed  Google Scholar 

  43. Vignes S, Bellanger J. Videocapsule endoscopy as a useful tool to diagnose primary intestinal lymphangiectasia. Rev Med Interne 2007;28:173–175.

    Article  PubMed  CAS  Google Scholar 

  44. Cave D, Legnani P, de Franchis R, Lewis BS. ICCE consensus for capsule retention. Endoscopy 2005;37:1065–1067.

    Article  PubMed  CAS  Google Scholar 

  45. Rey JF, Ladas S, Alhassani A, Kuznetsov K. European Society of Gastrointestinal Endoscopy (ESGE). Video capsule endoscopy: update to guidelines (May 2006). Endoscopy 2006;38:1047–1053.

    Article  PubMed  CAS  Google Scholar 

  46. May A, Nachbar L, Ell C. Extraction of entrapped capsules from the small bowel by means of push-and-pull enteroscopy with the double-balloon technique. Endoscopy 2005;37:591–593.

    Article  PubMed  CAS  Google Scholar 

  47. Tanaka S, Mitsui K, Shirakawa K, Tatsuguchi A, Nakamura T, Hayashi Y, et al. Successful retrieval of video capsule endoscopy retained at ileal stenosis of Crohn’s disease using double-balloon endoscopy. J Gastroenterol Hepatol 2006;21:922–923.

    Article  PubMed  Google Scholar 

  48. Guyomar Y, Vandeville L, Heuls S, Coviaux F, Graux P, Cornaert P, et al. Interference between pacemaker and video capsule endoscopy. Pacing Clin Electrophysiol 2004;27:1329–1330.

    Article  PubMed  Google Scholar 

  49. Payeras G, Piqueras J, Moreno VJ, Cabrera A, Menendez D, Jimenez R. Effects of capsule endoscopy on cardiac pacemakers. Endoscopy 2005;37:1181–1185.

    Article  PubMed  CAS  Google Scholar 

  50. Girelli CM, Tartara P, Vitali E. Lack of reciprocal interference between capsule endoscope and left ventricular assist device. Endoscopy 2006;38:94–95.

    Article  PubMed  CAS  Google Scholar 

  51. Lewis BS, Eisen GM, Friedman S. A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 2005;37:960–965.

    Article  PubMed  CAS  Google Scholar 

  52. Hartmann D, Eickhoff A, Damian U, Riemann JF. Diagnosis of small-bowel pathology using paired capsule endoscopy with two different devices: a randomized study. Endoscopy 2007;39:1041–1045.

    Article  PubMed  CAS  Google Scholar 

  53. Eliakim R, Sharma VK, Yassin K, Adler SN, Jacob H, Cave DR, et al. M2A esophageal capsule endoscopy is comparable to traditional upper endoscopy in detection of esophagitis and Barrett’s esophagus in patients with GERD symptoms (abstract). Am J Gastroenterol 2004;99:S3.

    Article  Google Scholar 

  54. Eisen GM, Eliakim R, Zaman A, Schwartz J, Faigel D, Rondonotti E, et al. The accuracy of PillCam ESO capsule endoscopy versus conventional upper endoscopy for the diagnosis of esophageal varices: a prospective three-center pilot study. Endoscopy 2006;38:31–35.

    Article  PubMed  CAS  Google Scholar 

  55. Lin OS, Schembre DB, Mergener K, Spaulding W, Lomah N, Ayub K, et al. Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux. Gastrointest Endosc 2007;65:577–583.

    Article  PubMed  Google Scholar 

  56. Eliakim R, Fireman Z, Gralnek IM, Yassin K, Waterman M, Kopelman Y, et al. Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study. Endoscopy 2006;38:963–970.

    Article  PubMed  CAS  Google Scholar 

  57. Schoofs N, Devière J, Van Gossum A. PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study. Endoscopy 2006;38:971–977.

    Article  PubMed  CAS  Google Scholar 

  58. Saurin JC. Capsule endoscopy. Endoscopy 2007;39:986–991.

    Article  PubMed  Google Scholar 

  59. Gay G, Delvaux M, Laurent V, Reibel N, Regent D, Grosdidier G, et al. Temporary intestinal occlusion induced by a “patency capsule” in a patient with Crohn’s disease. Endoscopy 2005;37:174–177.

    Article  PubMed  CAS  Google Scholar 

  60. Banerjee R, Bhargav P, Reddy P, Gupta R, Lakhtakia S, Tandan M, et al. Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical trial. J Gastroenterol Hepatol 2007;22:2060–2063.

    Article  PubMed  Google Scholar 

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Nakamura, T., Terano, A. Capsule endoscopy: past, present, and future. J Gastroenterol 43, 93–99 (2008). https://doi.org/10.1007/s00535-007-2153-6

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