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Endoscopic diagnosis of small intestinal diseases

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Abstract

The technological development in endoscopy is directed toward improved accuracy of the diagnoses of novel diseases. The capsule endoscope and balloon-assisted endoscope are examples of such technological development. By these novel technologies, the small intestine can be examined in more detail. Therefore, an increasing number of novel diseases have been discovered, requiring the establishment of diagnosis and treatment strategies for these unknown diseases. In particular, obscure gastrointestinal bleeding, Crohn’s disease, and nonsteroidal anti-inflammatory drug-induced enteropathy are of great interest to endoscopists. The capsule endoscope is the best method for screening the small intestine; however, the development of supporting methods such as the patency capsule is eagerly desired.

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References

  1. Fisher L, Lee Krinsky M, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, et al. The role of endoscopy in the management of obscure GI bleeding. Gastrointest Endosc. 2010;72:471–9.

    Article  PubMed  Google Scholar 

  2. Leighton JA, Goldstein J, Hirota W, Jacobson BC, Johanson JF, Mallery JS, et al. Obscure gastrointestinal bleeding. Gastrointest Endosc. 2003;58:650–5.

    Article  PubMed  Google Scholar 

  3. 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;126:643–53.

    Article  PubMed  Google Scholar 

  4. de Leusse A, Vahedi K, Edery J, Tiah D, Fery-Lemonnier E, Cellier C, et al. Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding? Gastroenterology 2007;132:855–62 (quiz 1164–5).

    Google Scholar 

  5. Pasha SF, Hara AK, Leighton JA. Diagnostic evaluation and management of obscure gastrointestinal bleeding: a changing paradigm. Gastroenterol Hepatol (N Y). 2009;5:839–50.

    Google Scholar 

  6. Carey EJ, Leighton JA, Heigh RI, Shiff AD, Sharma VK, Post JK, et al. A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 2007;102:89–95.

    Article  PubMed  Google Scholar 

  7. Triester SL, Leighton JA, Leontiadis GI, Gurudu SR, Fleischer DE, Hara AK, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol. 2006;101:954–64.

    Article  PubMed  Google Scholar 

  8. 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 

  9. Dionisio PM, Gurudu SR, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, et al. Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small-bowel Crohn’s disease: a meta-analysis. Am J Gastroenterol. 2010;105:1240–8 (quiz 1249).

    Google Scholar 

  10. Efthymiou A, Viazis N, Mantzaris G, Papadimitriou N, Tzourmakliotis D, Raptis S, et al. Does clinical response correlate with mucosal healing in patients with Crohn’s disease of the small bowel? A prospective, case-series study using wireless capsule endoscopy. Inflamm Bowel Dis. 2008;14:1542–7.

    Article  PubMed  Google Scholar 

  11. Jaffe TA, Gaca AM, Delaney S, Yoshizumi TT, Toncheva G, Nguyen G, et al. Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. Am J Roentgenol. 2007;189:1015–22.

    Article  Google Scholar 

  12. Jensen MD, Nathan T, Rafaelsen SR, Kjeldsen J. Diagnostic accuracy of capsule endoscopy for small bowel Crohn’s disease is superior to that of MR enterography or CT enterography. Clin Gastroenterol Hepatol. 2010;9:124–9.

    Article  PubMed  Google Scholar 

  13. Rondonotti E, Sunada K, Yano T, Paggi S, Yamamoto H. Double-balloon endoscopy in clinical practice: where are we now? Dig Endosc. 2012;24:209–19.

    Article  PubMed  Google Scholar 

  14. Legnani P, Kornbluth A. Video capsule endoscopy in inflammatory bowel disease 2005. Curr Opin Gastroenterol. 2005;21:438–42.

    PubMed  Google Scholar 

  15. Herrerias JM, Leighton JA, Costamagna G, Infantolino A, Eliakim R, Fischer D, et al. Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy. Gastrointest Endosc. 2008;67:902–9.

    Article  PubMed  Google Scholar 

  16. Bourreille A, Ignjatovic A, Aabakken L, Loftus EV Jr, Eliakim R, Pennazio M, et al. Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus. Endoscopy. 2009;41:618–37.

    Article  PubMed  CAS  Google Scholar 

  17. Gorlewicz JL, Battaglia S, Smith BF, Ciuti G, Gerding J, Menciassi A, et al. Wireless insufflation of the gastrointestinal tract. IEEE Trans Biomed Eng. 2012.

  18. Toennies JL, Ciuti G, Smith BF, Menciassi A, Valdastri P, Webster RJ. Toward tetherless insufflation of the GI tract. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:1946–9.

    PubMed  Google Scholar 

  19. Valdastri P, Quaglia C, Susilo E, Menciassi A, Dario P, Ho CN, et al. Wireless therapeutic endoscopic capsule: in vivo experiment. Endoscopy. 2008;40:979–82.

    Article  PubMed  CAS  Google Scholar 

  20. Graham DY, Opekun AR, Willingham FF, Qureshi WA. Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol. 2005;3:55–9.

    Article  PubMed  Google Scholar 

  21. 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;3:133–41.

    Article  PubMed  Google Scholar 

  22. Maiden L, Thjodleifsson B, Theodors A, Gonzalez J, Bjarnason I. A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy. Gastroenterology. 2005;128:1172–8.

    Article  PubMed  Google Scholar 

  23. Fujimori S, Gudis K, Takahashi Y, Seo T, Yamada Y, Ehara A, et al. Distribution of small intestinal mucosal injuries as a result of NSAID administration. Eur J Clin Investig. 2010;40:504–10.

    Article  CAS  Google Scholar 

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Acknowledgments

This work was supported by a Grant-in-Aid for Scientific Research (C) to Y. Naito (no. 22590705) and by an Adaptable and Seamless Technology Transfer Program through target-driven R&D to Y. Naito (no. AS2114020E) from the Japan Science and Technology Agency.

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The authors declare that they have no conflict of interest.

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Correspondence to Yuji Naito.

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Handa, O., Naito, Y., Okayama, T. et al. Endoscopic diagnosis of small intestinal diseases. Clin J Gastroenterol 6, 94–98 (2013). https://doi.org/10.1007/s12328-013-0364-3

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  • DOI: https://doi.org/10.1007/s12328-013-0364-3

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