Endoscopy 2009; 41(7): 618-637
DOI: 10.1055/s-0029-1214790
Review

© Georg Thieme Verlag KG Stuttgart · New York

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

A.  Bourreille[*] 1 , A.  Ignjatovic[*] 1 , L.  Aabakken1 , E.  V.  Loftus Jr1 , R.  Eliakim1 , M.  Pennazio1 , Y.  Bouhnik1 , E.  Seidman1 , M.  Keuchel1 , J.  G.  Albert1 , S.  Ardizzone1 , S.  Bar-Meir1 , R.  Bisschops1 , E.  J.  Despott1 , P.  F.  Fortun1 , R.  Heuschkel1 , J.  Kammermeier1 , J.  A.  Leighton1 , G.  J.  Mantzaris1 , D.  Moussata1 , S.  Lo1 , V.  Paulsen1 , J.  Panés1 , G.  Radford-Smith1 , W.  Reinisch1 , E.  Rondonotti1 , D.  S.  Sanders1 , J.  M.  Swoger1 , H.  Yamamoto1 , S.  Travis1 , J.-F.  Colombel1 , A.  Van Gossum1
  • 1on behalf of the World Organisation of Digestive Endoscopy (OMED) and the European Crohn’s and Colitis Organisation (ECCO)
Further Information

Publication History

Publication Date:
08 July 2009 (online)

Crohn’s disease and ulcerative colitis are lifelong diseases seen predominantly in the developed countries of the world.

Whereas ulcerative colitis is a chronic inflammatory condition causing diffuse and continuous mucosal inflammation of the colon, Crohn’s disease is a heterogeneous entity comprised of several different phenotypes, but can affect the entire gastrointestinal tract. A change in diagnosis from Crohn’s disease to ulcerative colitis during the first year of illness occurs in about 10 % – 15 % of cases. Inflammatory bowel disease (IBD) restricted to the colon that cannot be characterized as either ulcerative colitis or Crohn’s disease is termed IBD-unclassified (IBDU).

The advent of capsule and both single- and double-balloon-assisted enteroscopy is revolutionizing small-bowel imaging and has major implications for diagnosis, classification, therapeutic decision making and outcomes in the management of IBD. The role of these investigations in the diagnosis and management of IBD, however, is unclear.

This document sets out the current Consensus reached by a group of international experts in the fields of endoscopy and IBD at a meeting held in Brussels, 12–13th December 2008, organised jointly by the European Crohn’s and Colitis Organisation (ECCO) and the Organisation Mondiale d’Endoscopie Digestive (OMED). The Consensus is grouped into seven sections: definitions and diagnosis; suspected Crohn’s disease; established Crohn’s disease; IBDU; ulcerative colitis (including ileal pouch–anal anastomosis [IPAA]); paediatric practice; and complications and unresolved questions.

Consensus guideline statements are followed by comments on the evidence and opinion. Statements are intended to be read in context with qualifying comments and not read in isolation.

References

  • 1 Shivananda S, Lennard-Jones J, Logan R. et al . Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD).  Gut. 1996;  39 690-697
  • 2 Silverberg M, Satsangi J, Ahmad T. et al . Toward an integrated clinical molecular and serological classification of inflammatory bowel disease: report of a working party of the Montreal World Congress of Gastroenterology.  Can J Gastroenterol. 2005;  19 (Suppl A) 5A-36A
  • 3 Strange E F, Travis S PL, Vermeire S. et al . European evidence-based Consensus on the diagnosis and management of ulcerative colitis:Definitions and diagnosis.  J Crohn’s Colitis. 2007;  2 22
  • 4 Stange E F, Travis S, Vermeire S. et al . European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis.  Gut. 2006;  55 (Suppl 1) i1-i15
  • 5 Fink A, Kosecoff J, Chassin M, Brook R H. Consensus methods: characteristics and guidelines for use.  Am J Public Health. 1984;  74 979-983
  • 6 Centre for Evidence Based Medicine , Oxford .Levels of evidence and grades of recommendation. Available at: http://www.cebm.net/levels_of_evidence.asp
  • 7 Lin O S, Brandabur J J, Schembre D B. et al . Acute symptomatic small bowel obstruction due to capsule impaction.  Gastrointest Endosc. 2007;  65 725-728
  • 8 Carey E J, Leighton J A, Heigh R I. et al . A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding.  Am J Gastroenterol. 2007;  102 89-95
  • 9 Pennazio M, Arrigoni A, Risio M. et al . Clinical evaluation of push-type enteroscopy.  Endoscopy. 1995;  27 164-170
  • 10 Yamamoto H, Sekine Y, Sato Y. et al . Total enteroscopy with a nonsurgical steerable double-balloon method.  Gastrointest Endosc. 2001;  53 216-220
  • 11 Tsujikawa T, Saitoh Y, Andoh A. et al . Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences.  Endoscopy. 2008;  40 11-15
  • 12 Hotokezaka M, Jimi S I, Hidaka H. et al . Role of intraoperative enteroscopy for surgical decision making with Crohn’s disease.  Surg Endosc. 2007;  21 1238-1242
  • 13 Hotokezaka M, Jimi S, Hidaka H. et al . Intraoperative enteroscopy in minimally invasive surgery.  Surg Laparosc Endosc Percutan Tech. 2007;  17 492-494
  • 14 Klein O, Colombel J F, Lescut D. et al . Remaining small bowel endoscopic lesions at surgery have no influence on early anastomotic recurrences in Crohn’s disease.  Am J Gastroenterol. 1995;  90 1949-1952
  • 15 Akerman P A, Agrawal D, Cantero D, Pangtay J. Spiral enteroscopy with the new DSB overtube: a novel technique for deep peroral small-bowel intubation.  Endoscopy. 2008;  40 974-978
  • 16 Akerman P A, Agrawal D, Chen W. et al . Spiral enteroscopy: a novel method of enteroscopy by using the Endo-Ease Discovery SB overtube and a pediatric colonoscope.  Gastrointest Endosc. 2009;  69 327-332
  • 17 Molinie F, Gower-Rousseau C, Yzet T. et al . Opposite evolution in incidence of Crohn’s disease and ulcerative colitis in Northern France (1988–1999).  Gut. 2004;  53 843-848
  • 18 Lashner B. Clinical features, laboratory findings, and course of Crohn’s disease. In: Kirsner JV (ed) Inflammatory bowel disease. 5th edn. Philadelphia; Saunders 2000: 305-314
  • 19 Mow W S, Lo S K, Targan S R. et al . Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease.  Clin Gastroenterol Hepatol. 2004;  2 31-40
  • 20 Hara A K, Leighton J A, Heigh R I. et al . Crohn disease of the small bowel: preliminary comparison among CT enterography, capsule endoscopy, small-bowel follow-through, and ileoscopy.  Radiology. 2006;  238 128-134
  • 21 Solem C A, Loftus Jr E V, Fletcher J G. et al . Small-bowel imaging in Crohn’s disease: a prospective, blinded, 4-way comparison trial.  Gastrointest Endosc. 2008;  68 255-266
  • 22 Voderholzer W A, Beinhoelzl J, Rogalla P. et al . Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis.  Gut. 2005;  54 369-373
  • 23 Dubcenco E, Jeejeebhoy K N, Petroniene R. et al . Capsule endoscopy findings in patients with established and suspected small-bowel Crohn’s disease: correlation with radiologic, endoscopic, and histologic findings.  Gastrointest Endosc. 2005;  62 538-544
  • 24 Chong A K, Taylor A, Miller A. et al . Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn’s disease.  Gastrointest Endosc. 2005;  61 255-261
  • 25 Golder S K, Schreyer A G, Endlicher E. et al . Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease.  Int J Colorectal Dis. 2006;  21 97-104
  • 26 Marmo R, Rotondano G, Piscopo R. et al . Capsule endoscopy versus enteroclysis in the detection of small-bowel involvement in Crohn’s disease: a prospective trial.  Clin Gastroenterol Hepatol. 2005;  3 772-776
  • 27 Rokkas T, Papaxoinis K, Triantafyllou K. et al . Does purgative preparation influence the diagnostic yield of small bowel video capsule endoscopy? A meta-analysis.  Am J Gastroenterol. 2009;  104 219-227
  • 28 Sidhu R, Sanders D S, Morris A J, McAlindon M E. Guidelines on small bowel enteroscopy and capsule endoscopy in adults.  Gut. 2008;  57 125-136
  • 29 Graham D Y, Opekun A R, Willingham F F, Qureshi W A. Visible small-intestinal mucosal injury in chronic NSAID users.  Clin Gastroenterol Hepatol. 2005;  3 55-59
  • 30 Maiden L, Thjodleifsson B, Seigal A. et al . Long-term effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective agents on the small bowel: a cross-sectional capsule enteroscopy study.  Clin Gastroenterol Hepatol. 2007;  5 1040-1045
  • 31 Hawkey C J, Ell C, Simon B. et al . Less small-bowel injury with lumiracoxib compared with naproxen plus omeprazole.  Clin Gastroenterol Hepatol. 2008;  6 536-544
  • 32 Mary J Y, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn’s disease: a prospective multicentre study. Groupe d’Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID).  Gut. 1989;  30 983-989
  • 33 Daperno M, D’Haens G, Van Assche G. et al . Development and validation of a new, simplified endoscopic activity score for Crohn’s disease: the SES-Crohn’s Disease.  Gastrointest Endosc. 2004;  60 505-512
  • 34 Rutgeerts P, Geboes K, Vantrappen G. et al . Predictability of the postoperative course of Crohn’s disease.  Gastroenterology. 1990;  99 956-963
  • 35 Gralnek I M, Defranchis R, Seidman E. et al . Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change.  Aliment Pharmacol Ther. 2008;  27 146-154
  • 36 Gal E, Geller A, Fraser G. et al . Assessment and validation of the new Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI).  Dig Dis Sci. 2008;  53 1933-1937
  • 37 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease.  Gastroenterology. 2002;  123 999-1005
  • 38 Toth E, Fork F-T, Almqvist P. et al . Wireless capsule endoscopy: a comparison with enterography, push enteroscopy and ileocolonoscopy in the diagnosis of small bowel Crohn’s disease [abstract].  Gastrointest Endosc. 2004;  59 P173
  • 39 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease.  Eur J Gastroenterol Hepatol. 2003;  15 363-367
  • 40 Marmo R, Rotondano G, Piscopo R. et al . Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases.  Aliment Pharmacol Ther. 2005;  22 595-604
  • 41 Apostolopoulos P, Giannakoulopoulou E, Papanikolaou I. et al . M2A wireless capsule endoscopy versus enteroclysis: A prospective study in 68 patients with suspected small bowel disease [abstract].  Gastrointest Endosc. 2004;  59 P147
  • 42 Liangpunsakul S, Chadalawada V, Rex D K. et al . Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis.  Am J Gastroenterol. 2003;  98 1295-1298
  • 43 Triester S L, Leighton J A, Leontiadis G I. 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;  101 954-964
  • 44 Albert J G, Martiny F, Krummenerl A. et al . Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis.  Gut. 2005;  54 1721-1727
  • 45 Voderholzer W A, Ortner M, Rogalla P. et al . Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis.  Endoscopy. 2003;  35 1009-1014
  • 46 Chang D K, Kim J J, Choi H. et al . Double balloon endoscopy in small intestinal Crohn’s disease and other inflammatory diseases such as cryptogenic multifocal ulcerous stenosing enteritis (CMUSE).  Gastrointest Endosc. 2007;  66 S96-S98
  • 47 Heine G D, Hadithi M, Groenen M J. et al . Double-balloon enteroscopy: indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease.  Endoscopy. 2006;  38 42-48
  • 48 Gay G, Delvaux M. Double balloon enteroscopy in Crohn’s disease and related disorders: our experience.  Gastrointest Endosc. 2007;  66 S82-90
  • 49 Seiderer J, Herrmann K, Diepolder H. et al . Double-balloon enteroscopy versus magnetic resonance enteroclysis in diagnosing suspected small-bowel Crohn’s disease: results of a pilot study.  Scand J Gastroenterol. 2007;  42 1376-1385
  • 50 Cazzato I A, Cammarota G, Nista E C. et al . Diagnostic and therapeutic impact of double-balloon enteroscopy (DBE) in a series of 100 patients with suspected small bowel diseases.  Dig Liver Dis. 2007;  39 483-487
  • 51 Pennazio M, Sprujevnik T, Arrigoni A. et al . Outcome of double-balloon enteroscopy after capsule endoscopy in patients with suspected small-bowel disease [abstract].  Gastrointest Endosc. 2006;  63 AB90
  • 52 Lo S K, Ross A A, Leighton J A. et al . Double balloon enteroscopy: An initial multicenter U.S. experience.  Am J Gastroenterol. 2005;  100 S103
  • 53 Jo J, Byeon J, Choi K. et al . Comparison of double balloon enteroscopy and small bowel series for the evaluation of small bowel lesions.  Korean J Gastroenterol. 2006;  48 55-57
  • 54 Benz C, Jakobs R, Riemann J F. Do we need the overtube for push-enteroscopy?.  Endoscopy. 2001;  33 658-661
  • 55 Foutch P G, Sawyer R, Sanowski R A. Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure origin.  Gastrointest Endosc. 1990;  36 337-341
  • 56 Ogoshi K, Hara Y, Ashizawa S. New technic for small intestinal fiberoscopy.  Gastrointest Endosc. 1973;  20 64-65
  • 57 Appleyard M, Fireman Z, Glukhovsky A. et al . A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions.  Gastroenterology. 2000;  119 1431-1438
  • 58 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy.  Nature. 2000;  405 417
  • 59 May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease.  Gastrointest Endosc. 2005;  62 62-70
  • 60 Pohl J, May A, Nachbar L, Ell C. Diagnostic and therapeutic yield of push-and-pull enteroscopy for symptomatic small bowel Crohn’s disease strictures.  Eur J Gastroenterol Hepatol. 2007;  19 529-534
  • 61 Rossini F P, Pennazio M. Small-bowel endoscopy.  Endoscopy. 2002;  34 13-20
  • 62 Yamamoto H, Yano T, Kita H. et al . New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders.  Gastroenterology. 2003;  125 1556-1557
  • 63 Manno M, Mussetto A, Conigliaro R. Preliminary results of alternative „simultaneous” technique for single-balloon enteroscopy.  Endoscopy. 2008;  40 538
  • 64 Herrerias J M, Leighton J A, Costamagna G. et al . Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy.  Gastrointest Endosc. 2008;  67 902-909
  • 65 Saurin J C, Maunoury V, Lapalus M G. et al . International consensus in Paris, 2006, on the indications and use of the endoscopic videocapsule test. Report of the SFED capsule commission.  Gastroenterol Clin Biol. 2007;  31 798-805
  • 66 Postgate A J, Burling D, Gupta A. et al . Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: A 3-year technical review.  Dig Dis Sci. 2008;  53 2732-2738
  • 67 Eliakim R, Suissa A, Yassin K. et al . Wireless capsule video endoscopy compared to barium follow-through and computerised tomography in patients with suspected Crohn’s disease – final report.  Dig Liver Dis. 2004;  36 519-522
  • 68 Rajesh A, Sandrasegaran K, Jennings S G. et al . Comparison of capsule endoscopy with enteroclysis in the investigation of small bowel disease.  Abdom Imaging. 2008;  June 11 [epub ahead of print]
  • 69 Tillack C, Seiderer J, Brand S. et al . Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoscopy (CE) in the diagnosis of small bowel lesions in Crohn’s disease.  Inflamm Bowel Dis. 2008;  14 1219-1228
  • 70 Olaison G, Smedh K, Sjodahl R. Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms.  Gut. 1992;  33 331-335
  • 71 Bourreille A, Jarry M, D’Halluin P N. et al . Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn’s disease: a prospective study.  Gut. 2006;  55 978-982
  • 72 Pons B eltran, Nos P, Bastida G. et al . Evaluation of postsurgical recurrence in Crohn’s disease: a new indication for capsule endoscopy?.  Gastrointest Endosc. 2007;  66 533-540
  • 73 Efthymiou A, Viazis N, Mantzaris G. 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 1542-1547
  • 74 Oshitani N, Yukawa T, Yamagami H. et al . Evaluation of deep small bowel involvement by double-balloon enteroscopy in Crohn’s disease.  Am J Gastroenterol. 2006;  101 1484-1489
  • 75 Choi H, Choi K Y, Eun C S. et al . Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study.  Gastrointest Endosc. 2007;  66 S22-S25
  • 76 Despott E J, Tripoli E, Polecina A. et al . Double balloon enteroscopy: A leap forward in the management of small bowel Crohn’s strictures.  Gastrointest Endosc. 2008;  67 AB273
  • 77 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
  • 78 Keuchel M. Double balloon (push-and-pull) enteroscopy: breakthrough in the management of small intestinal strictures in Crohn’s disease?.  Eur J Gastroenterol Hepatol. 2007;  19 523-525
  • 79 Sunada K, Yamamoto H, Kita H. et al . Balloon dilatation of small-intestinal benign strictures using double-balloon endoscopy.  Gastrointest Endosc. 2005;  61 AB183
  • 80 Sunada K, Yamamoto H, Kita H. et al . Endoscopic balloon dilation therapy for small intestinal strictures with Crohn’s disease using double balloon endoscopy.  Gastrointest Endosc. 2007;  65 AB91
  • 81 Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy.  Endoscopy. 2006;  38 49-58
  • 82 Mehdizadeh S, Han N J, Cheng D W. et al . Success rate of retrograde double-balloon enteroscopy.  Gastrointest Endosc. 2007;  65 633-639
  • 83 Mehdizadeh S, Ross A, Gerson L. et al . What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 US tertiary care centers.  Gastrointest Endosc. 2006;  64 740-750
  • 84 Gerson L, Chiorean M, Tokar J. et al . Complications associated with double balloon enteroscopy: the US experience.  Am J Gastroenterol. 2008;  103 S109-S110
  • 85 Di Caro S, May A, Heine D GN. et al . The European experience with double-balloon enteroscopy: indications, methodology, safety, and clinical impact.  Gastrointest Endosc. 2005;  62 545-550
  • 86 Pasha S F, Leighton J A, Das A. et al . Double-balloon enteroscopy and capsule endoscopy have comparable diagnostic yield in small-bowel disease: a meta-analysis.  Clin Gastroenterol Hepatol. 2008;  6 671-676
  • 87 Vind I, Riis L, Jess T. et al . Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database.  Am J Gastroenterol. 2006;  101 1274-1282
  • 88 Stewenius J, Adnerhill I, Ekelund G. et al . Ulcerative colitis and indeterminate colitis in the city of Malmo, Sweden. A 25-year incidence study.  Scand J Gastroenterol. 1995;  30 38-43
  • 89 Price A B. Overlap in the spectrum of non-specific inflammatory bowel disease – „colitis indeterminate”.  J Clin Pathol. 1978;  31 10
  • 90 Geboes K, Colombel J F, Greenstein A. et al . Indeterminate colitis: a review of the concept – what’s in a name?.  Inflamm Bowel Dis. 2008;  14 850-857
  • 91 Satsangi J, Silverberg M S, Vermeire S, Colombel J F. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications.  Gut. 2006;  55 749-753
  • 92 Maunoury V, Sovoye G, Bourreille A. et al . Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified).  Inflamm Bowel Dis. 2007;  13 152-155
  • 93 Mehdizadeh S, Chen G, Enayati P J. et al . Diagnostic yield of capsule endoscopy in ulcerative colitis and inflammatory bowel disease of unclassified type (IBDU).  Endoscopy. 2008;  40 30-35
  • 94 Lo S, Zaidel O, Tabibzadef S. Utility of wireless capsule endoscopy (WCE) and IBD serology in re-classifying indeterminate colitis (IC).  Gastroenterology. 2003;  124 S1310
  • 95 Hume G, Whitaker D, Radford-Smith G. et al .Can capsule endoscopy (CE) help diffrentiate the aetiology of indeterminate colitis (IC)? Proceedings of the 3rd International Conference on Capsule Endoscopy, Miami, Florida, 2004 : 38A. 
  • 96 Mascaranhas-Saraiva , Baldaque-Silva F, Villas-Boas G. et al .Capsule endoscopy: a valuable help for the differential diagnosis of indeterminate colitis? Proceedings of the 4th International Conference on Capsule Endoscopy, Miami, Florida, USA, 2005. 
  • 97 Llach L, Mata A, Pellise M. et al .The role of capsule endoscopy in patients with indeterminate colitis. Preliminary results of a prospective trial. Proceedings of the 5th International Conference on Capsule Endoscopy, Paris, 2006. 
  • 98 Erber J, Erber W, Harwayne-Gidansky I. et al . Capsule endoscopy in patients with suspected and known Crohn’s disease: correlation with IBD serology [abstract].  Am J Gastroenterol. 2006;  101 S452
  • 99 Galter S, Gonzales B, Montfort D. et al . Usefulness of capsule endoscopy in the study of the inflammatory bowel disease: preliminary results [abstract].  Gastroenterology. 2006;  130 A478
  • 100 Santos S, Erber J, Legnani P. et al . Capsule endoscopy in patients with known IBD: frequency of findings, and influence on medical and surgical management are based upon indications for CE [abstract].  Am J Gastroenterol. 2006;  101 S462
  • 101 Viazis N, Karamanolis D G. Indeterminate colitis – the role of wireless capsule endoscopy.  Aliment Pharmacol Ther. 2007;  25 859; author reply 860
  • 102 Joossens S, Reinisch W, Vermeire S. et al . The value of serologic markers in indeterminate colitis: a prospective follow-up study.  Gastroenterology. 2002;  122 1242-1247
  • 103 Henriksen M, Jahnsen J, Lygren I. et al . Change of diagnosis during the first five years after onset of inflammatory bowel disease: results of a prospective follow-up study (the IBSEN Study).  Scand J Gastroenterol. 2006;  41 1037-1043
  • 104 Moum B, Vatn M H, Ekbom A. et al . Incidence of ulcerative colitis and indeterminate colitis in four counties of southeastern Norway, 1990–93. A prospective population-based study. The Inflammatory Bowel South-Eastern Norway (IBSEN) Study Group of Gastroenterologists.  Scand J Gastroenterol. 1996;  31 362-366
  • 105 Schluender S, Mehdizadeh S, Vasiliaukas A. et al . Does preoperative wireless endoscopic capsule predict long-term outcome after ileal pouch–anal anastomosis (IPAA)? [abstract].  Gastroenterology. 2006;  130 A214
  • 106 Shen B, Remzi F H, Santisi J. et al . Application of wireless capsule endoscopy for the evaluation of iron deficiency anemia in patients with ileal pouches.  J Clin Gastroenterol. 2008;  42 897-902
  • 107 Calabrese C, Fabbri A, Gionchetti P. et al . Controlled study using wireless capsule endoscopy for the evaluation of the small intestine in chronic refractory pouchitis.  Aliment Pharmacol Ther. 2007;  25 1311-1316
  • 108 Guilhon De Araujo Sant’Anna A M, Dubois J. et al . Wireless capsule endoscopy for obscure small-bowel disorders: Final results of the first pediatric controlled trial.  Clin Gastroenterol Hepatol. 2005;  3 264-270
  • 109 Rey J F, Ladas S, Alhassani A, Kuznetsov K. ESGE Guidelines Committee. European Society of Gastrointestinal Endoscopy (ESGE).  Video capsule endoscopy: update to guidelines (May 2006). 2006;  38 1047-1063
  • 110 Lee K, Anderson M. ASGE Standards of Practice Committee . Modifications in endoscopic practice for pediatric patients.  Gastrointest Endosc. 2008;  67 1-9
  • 111 De Angelis G L, Fornaroli F, De Angelis N. et al . Wireless capsule endoscopy for pediatric small-bowel diseases.  Am J Gastroenterol. 2007;  102 1749-1757
  • 112 Cohen S A, Gralnek I M, Ephrath H. et al . Capsule endoscopy may reclassify pediatric inflammatory bowel disease: a historical analysis.  J Pediatr Gastroenterol Nutr. 2008;  47 31-36
  • 113 Urbain D, Tresinie M, De Looze D. et al . Capsule endoscopy in paediatrics: Multicentric Belgian study.  Acta Gastroenterol Belg. 2007;  70 11-14
  • 114 Thomson M, Fritscher-Ravens A, Mylonaki M. et al . Wireless capsule endoscopy in children: A study to assess diagnostic yield in small bowel disease in paediatric patients.  J Pediatr Gastroenterol Nutr. 2007;  44 192-197
  • 115 Moy L, Levine J. Wireless capsule endoscopy in the pediatric age group: Experience and complications.  J Pediatr Gastroenterol Nutr. 2007;  44 516-520
  • 116 Antao B, Bishop J, Shawis R, Thomson M. Clinical application and diagnostic yield of wireless capsule endoscopy in children.  J Laparoendosc Adv Surg Tech A. 2007;  17 364-370
  • 117 Arguelles-Arias F, Caunedo A, Romero J. et al . The value of capsule endoscopy in pediatric patients with a suspicion of Crohn’s disease.  Endoscopy. 2004;  36 869-873
  • 118 Ge Z Z, Chen H Y, Gao Y J. et al . Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases.  Eur J Pediatrics. 2007;  166 825-829
  • 119 Shamir R, Hino B, Hartman C. et al . Wireless video capsule in pediatric patients with functional abdominal pain.  J Pediatr Gastroenterol Nutr. 2007;  44 45-50
  • 120 Carvalho R S, Abadom V, Dilworth H P. et al . Indeterminate colitis: a significant subgroup of pediatric IBD.  Inflamm Bowel Dis. 2006;  12 258-262
  • 121 Kurugoglu S, Korman U, Adaletli I, Selcuk D. Enteroclysis in older children and teenagers.  Pediatr Radiol. 2007;  37 457-466
  • 122 Baath L, Ekberg O, Borulf S. et al . Small bowel barium examination in children. Diagnostic accuracy and clinical value as evaluated from 331 enteroclysis and follow-through examinations.  Acta Radiol. 1989;  30 621-626
  • 123 Lipson A, Bartram C I, Williams C B. et al . Barium studies and ileoscopy compared in children with suspected Crohn’s disease.  Clin Radiol. 1990;  41 5-8
  • 124 Halligan S, Nicholls S, Beattie R M. et al . The role of small bowel radiology in the diagnosis and management of Crohn’s disease.  Acta Paediatr. 1995;  84 1375-1378
  • 125 Batres L A, Maller E S, Ruchelli E. et al . Terminal ileum intubation in pediatric colonoscopy and diagnostic value of conventional small bowel contrast radiography in pediatric inflammatory bowel disease.  J Pediatr Gastroenterol Nutr. 2002;  35 320-323
  • 126 Gaca A M, Jaffe T A, Delaney S. et al . Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease.  Pediatric Radiology. 2008;  38 285-291
  • 127 Jamieson D H, Shipman P J, Israel D M, Jacobson K. Comparison of multidetector CT and barium studies of the small bowel: inflammatory bowel disease in children.  AJR American Journal of Roentgenology. 2003;  180 1211-1216
  • 128 Charron M, di Lorenzo C, Kocoshis S. CT and 99mTc-WBC vs colonoscopy in the evaluation of inflammation and complications of inflammatory bowel diseases.  J Gastroenterol Hepatol. 2002;  37 23-28
  • 129 Durno C A, Sherman P, Williams T. et al . Magnetic resonance imaging to distinguish the type and severity of pediatric inflammatory bowel diseases.  J Pediatr Gastroenterol Nutr. 2000;  30 170-174
  • 130 Laghi A, Borrelli O, Paolantonio P. et al . Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease.  Gut. 2003;  52 393-397
  • 131 Pilleul F, Godefroy C, Yzebe-Beziat D. et al . Magnetic resonance imaging in Crohn’s disease.  Gastroenterol Clin Biol. 2005;  29 803-808
  • 132 Darbari A, Sena L, Argani P. et al . Gadolinium-enhanced magnetic resonance imaging: A useful radiological tool in diagnosing pediatric IBD.  Inflamm Bowel Dis. 2004;  10 67-72
  • 133 Masselli G, Casciani E, Polettini E, Gualdi G. Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn’s disease.  Eur Radiol. 2008;  18 438-447
  • 134 Davies G R, Benson M J, Gertner D J. et al . Diagnostic and therapeutic push type enteroscopy in clinical use.  Gut. 1995;  37 346-352
  • 135 Darbari A, Kalloo A N, Cuffari C. Diagnostic yield, safety, and efficacy of push enteroscopy in pediatrics.  Gastrointest Endosc. 2006;  64 224-228
  • 136 Xu C D, Deng C H, Zhong J, Zhang C L. [Application of double-balloon push enteroscopy in diagnosis of small bowel disease in children].  Zhonghua Er Ke Za Zhi. 2006;  44 90-92
  • 137 Biagi F, Rondonotti E, Campanella J. et al . Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers.  Clin Gastroenterol Hepatol. 2006;  4 998-1003
  • 138 van Tuyl S A, den Ouden H, Stolk M F, Kuipers E J. Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study.  Endoscopy. 2007;  39 1037-1040
  • 139 Dai N, Gubler C, Hengstler P. et al . Improved capsule endoscopy after bowel preparation.  Gastrointest Endosc. 2005;  61 28-31
  • 140 Viazis N, Sgouros S, Papaxoinis K. et al . Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study.  Gastrointest Endosc. 2004;  60 534-538
  • 141 Cheifetz A S, Kornbluth A A, Legnani P. et al . The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease.  Am J Gastroenterol. 2006;  101 2218-2222
  • 142 Cheifetz A S, Lewis B S. Capsule endoscopy retention: is it a complication?.  J Clin Gastroenterol. 2006;  40 688-691
  • 143 Cheon J H, Kim Y S, Lee I S. et al . Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.  Endoscopy. 2007;  39 1046-1052
  • 144 Rondonotti E, Herrerias J M, Pennazio M. et al . Complications, limitations, and failures of capsule endoscopy: a review of 733 cases.  Gastrointest Endosc. 2005;  62 712-716; quiz 752, 754
  • 145 Sturniolo G C, Di Leo V, Vettorato M G. et al . Small bowel exploration by wireless capsule endoscopy: results from 314 procedures.  Am J Med. 2006;  119 341-347
  • 146 Buchman A L, Miller F H, Wallin A. et al . Videocapsule endoscopy versus barium contrast studies for the diagnosis of Crohn’s disease recurrence involving the small intestine.  Am J Gastroenterol. 2004;  99 2171-2177
  • 147 Goldstein J L, Eisen G M, Lewis B. et al . Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo.  Clin Gastroenterol Hepatol. 2005;  3 133-141
  • 148 Leighton J A, Srivathsan K, Carey E J. et al . Safety of wireless capsule endoscopy in patients with implantable cardiac defibrillators.  Am J Gastroenterol. 2005;  100 1728-1731
  • 149 Dubner S, Dubner Y, Gallino S. et al . Electromagnetic interference with implantable cardiac pacemakers by video capsule.  Gastrointest Endosc. 2005;  61 250-254
  • 150 Bandorski D, Irnich W, Bruck M. et al . Capsule endoscopy and cardiac pacemakers: investigation for possible interference.  Endoscopy. 2008;  40 36-39
  • 151 Yang R, Laine L. Mucosal stripping: a complication of push enteroscopy.  Gastrointest Endosc. 1995;  41 156-158
  • 152 Landi B, Cellier C, Fayemendy L. et al . Duodenal perforation occurring during push enteroscopy.  Gastrointest Endosc. 1996;  43 631
  • 153 Wilmer A, Rutgeerts P. Push enteroscopy. Technique, depth, and yield of insertion.  Gastrointest Endosc Clin N Am. 1996;  6 759-776
  • 154 Chong J, Tagle M, Barkin J S, Reiner D K. Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathology.  Am J Gastroenterol. 1994;  89 2143-2146
  • 155 Shimizu S, Tada M, Kawai K. Development of a new insertion technique in push-type enteroscopy.  Am J Gastroenterol. 1987;  82 844-847
  • 156 Zaman A, Sheppard B, Katon R M. Total peroral intraoperative enteroscopy for obscure GI bleeding using a dedicated push enteroscope: diagnostic yield and patient outcome.  Gastrointest Endosc. 1999;  50 506-510
  • 157 Kopacova M, Rejchrt S, Tacheci I, Bures J. Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy.  Gastrointest Endosc. 2007;  66 1133-1138
  • 158 Honda K, Itaba S, Mizutani T. et al . An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: an association with the development of pancreatitis.  Endoscopy. 2006;  38 1040-1043
  • 159 Jarbandhan S VA, van Weyenberg S JB, van der Veer W M. et al . Double balloon endoscopy associated pancreatitis: a description of six cases.  World J Gastroenterol. 2008;  14 720-724
  • 160 Mensink P BF, Haringsma J, Kucharzik T. et al . Complications of double balloon enteroscopy: a multicenter survey.  Endoscopy. 2007;  39 613-615
  • 161 Moschler O, May A D, Muller M K, Ell C. [Complications in double-balloon-enteroscopy: results of the German DBE register].  Z Gastroenterol. 2008;  46 266-270
  • 162 Kastin D A, Buchman A L, Barrett T. et al . Strictures from Crohn’s disease diagnosed by video capsule endoscopy.  J Clin Gastroenterol. 2004;  38 346-349
  • 163 Lewis B. Capsule endoscopy – transit abnormalities.  Gastrointest Endosc Clin N Am. 2006;  16 221-228, vii
  • 164 Sears D M, Avots-Avotins A, Culp K, Gavin M W. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin.  Gastrointest Endosc. 2004;  60 822-827
  • 165 Baichi M M, Arifuddin R M, Mantry P S. What we have learned from 5 cases of permanent capsule retention.  Gastrointest Endosc. 2006;  64 283-287
  • 166 Fry L C, De Petris G, Swain J M, Fleischer D E. Impaction and fracture of a video capsule in the small bowel requiring laparotomy for removal of the capsule fragments.  Endoscopy. 2005;  37 674-676
  • 167 Repici A, Barbon V, De AC . et al . Acute small-bowel perforation secondary to capsule endoscopy.  Gastrointest Endosc. 2008;  67 180-183
  • 168 Lee B-I, Choi H, Choi K-Y. et al . Retrieval of a retained capsule endoscope by double-balloon enteroscopy.  Gastrointest Endosc. 2005;  62 463-465
  • 169 Tanaka S, Mitsui K, Shirakawa K. 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
  • 170 Banerjee R, Bhargav P, Reddy P. 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
  • 171 Spada C, Shah S K, Riccioni M E. et al . Video capsule endoscopy in patients with known or suspected small bowel stricture previously tested with the dissolving patency capsule.  J Clin Gastroenterol. 2007;  41 576-582
  • 172 Signorelli C, Rondonotti E, Villa F. et al . Use of the Given Patency System for the screening of patients at high risk for capsule retention.  Dig Liver Dis. 2006;  38 326-330
  • 173 Sachdev M S, Leighton J A, Fleischer D E. et al . A prospective study of the utility of abdominal radiographs after capsule endoscopy for the diagnosis of capsule retention.  Gastrointest Endosc. 2007;  66 894-900
  • 174 De Bona M, Bellumat A, Cian E. et al . Capsule endoscopy findings in patients with suspected Crohn’s disease and biochemical markers of inflammation.  Dig Liver Dis. 2006;  38 331-335
  • 175 Valle J, Alcantara M, Perez-Grueso M J. et al . Clinical features of patients with negative results from traditional diagnostic work-up and Crohn’s disease findings from capsule endoscopy.  J Clin Gastroenterol. 2006;  40 692-696
  • 176 Fidder H H, Nadler M, Lahat A. et al . The utility of capsule endoscopy in the diagnosis of Crohn’s disease based on patient’s symptoms.  J Clin Gastroenterol. 2007;  41 384-387
  • 177 Shim K-N, Kim Y-S, Kim K-J. et al . Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study.  Scand J Gastroenterol. 2006;  41 983-988
  • 178 Bardan E, Nadler M, Chowers Y. et al . Capsule endoscopy for the evaluation of patients with chronic abdominal pain.  Endoscopy. 2003;  35 688-689
  • 179 May A, Manner H, Schneider M. et al . Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study).  Endoscopy. 2007;  39 606-612
  • 180 Adler S N, Bjarnason I, Metzger Y C. New balloon-guided technique for deep small-intestine endoscopy using standard endoscopes.  Endoscopy. 2008;  40 502-505
  • 181 Pennazio M, Santucci R, Rondonotti E. et al . Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases.  Gastroenterology. 2004;  126 643-653
  • 182 Li F, Gurudu S R, De Petris G. et al . Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures.  Gastrointest Endosc. 2008;  68 174-180

1 Contributed equally

A. Van GossumMD 

Department of Gastroenterology, Hepatopancreatology and GI Oncology
Erasme University Hospital, Université Libre de Bruxelles

Route de Lennik 808
1070 Brussels
Belgium

Fax: +32-2-5554697

Email: Andre.VanGossum@erasme.ulb.ac.be