Is colon capsule endoscopy useful for Barrett's prescreening?

Background: Colon capsule endoscopy (CCE) is a novel, non-invasive and painless method for the direct visualization of large bowel without intubation. After the activation, the camera shuts off in 3 minutes in order to save the battery energy, and it automatically turns back after 105 minutes, before leaving the small bowel. This short 3 minutes camera activity in the oesophagus offers the visual demonstration of the distal oesophagus and Z-line.

Methods and aims: From the November of 2008 colon capsule endoscopy was performed with the PillCam Colon (Given Imaging Ltd.) device in 14 cases. Eight out of these 14 patients underwent oesophago-gastroscopy-duodenoscopy (EGD) as well. The aim of our retrospective analysis was to evaluate the Z-line pictures presented by the colon capsule, and to compare those images with the conventional EGD results.

Results: The colon capsule showed the entire lenght of the oesophagus in each cases. The gastro-oesophageal junction and Z-line was visible in 71% of the cases with 79% appearance of the whole Z-line circumference.

We had parallel image results with CCE and EGD of the distal oesophagus and Z-line in 6 cases. CCE indicated suspected Barrett's oesohagus in one case however the EGD showed reflux oesophagitis grade Los-Angeles B. Mild irregularity of Z-line was detected by CCE in 3 cases all of them confirmed by EGD.

Conclusion: Although colon capsule endoscopy is designed for visualization of the colon mucosa, additionally it also shows the squamo-columnar Z-line in almost all cases. Therefore this method might be useful for prescreening Barrett's oesohagus as well.