ROLE OF THE NOVEL INTRODUCED PAN-INTESTINAL CAPSULE ENDOSCOPY SYSTEM IN CELIAC DISEASE

Aims:

Capsule endoscopy has proven its efficacy in diagnosing villous atrophy and lymphoma in patients with celiac disease. Most recently, a novel capsule endoscopy system was introduced, allowing for visualization of the small and large bowel. Its role in patients with celiac disease has not been evaluated yet.

Primary objective of the study was to evaluate the role of the novel pan-intestinal capsule system in patients with established celiac disease.

Methods:

Consecutive patients with established celiac disease (Marsh 0 – 3c) were included in this prospective single-center study. All patients received standard bowel preparation prior to the examination. Diagnostic yield, therapeutic impact and safety were analysed. In addition, concordance of capsule findings with histology and nutritional status in patients with symptomatic or refractory celiac disease were assessed.

Results:

Pan-intestinal capsule endoscopy was feasible in all cases and acceptable quality was also achieved in all cases following the standard bowel preparation. Villous atrophy was correctly identified in all patients with Marsh 3. Concordance of capsule findings with histology for villous atrophy showed a good correlation (kappa 0.45). No lymphomas were detected. Evaluation of the large bowel revealed diminutive polyps (size 4 mm in median) in 30% of patients.

Conclusions:

The novel introduced pan-intestinal capsule endoscopy system shows a fair correlation with histology and nutritional status in patients with symptomatic or refractory celiac disease. Of note, the capsule revealed colon polyps in up to 30% of patients. Therefore, the novel pan-intestinal capsule endoscopy system should be considered for patients with celiac disease and an indication for small-bowel endoscopy.