Background and Study Aims: Patients with spondyloarthropathies are often found to have signs of small-bowel
inflammation when examined by ileocolonoscopy. Because capsule endoscopy has been
found to be superior to other endoscopic and radiological modalities in the detection
of small-bowel inflammation, we aimed to compare the diagnostic yield of capsule endoscopy
with that of ileocolonoscopy in the detection of small-bowel lesions in patients with
spondyloarthropathies.
Patients and Methods: Twenty patients with documented seronegative peripheral arthritis, ankylosing spondylitis,
or sacroiliitis, who had not taken nonsteroidal anti-inflammatory drugs (NSAIDs) in
the preceding 2 months, participated in the study. The patients underwent capsule
endoscopy, followed by ileocolonoscopy within 7 days, with blinded assessment of both
examinations. Biopsies were taken when indicated and adverse events were monitored.
Patients completed a questionnaire on their satisfaction with the two procedures.
Results: A total of 20 patients (11 men, 9 women; mean age 41 ± 13 years) with seronegative
inflammatory spondyloarthropathies but without abdominal complaints completed the
study. No adverse effects were reported and all the capsules were excreted. Of these
20 patients, 11 (55 %) had a normal small bowel on both examinations. Significant
small-bowel findings (erythema, mucosal breaks, aphthous or linear ulcers, erosions)
were detected by capsule endoscopy in six patients (30 %) and by ileocolonoscopy in
only one patient. In addition, capsule endoscopy detected significant upper gastrointestinal
pathology in 40 % of patients. The patients preferred capsule endoscopy to ileocolonoscopy.
Conclusions: Capsule endoscopy detected more small-bowel lesions than ileocolonoscopy, and provided
additional potentially relevant information on upper gastrointestinal pathology in
patients with spondyloarthropathies.
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R. Eliakim, M.D.
Department of Gastroenterology
Rambam Medical Center · Haifa 31096 · Israel·
Fax: +972-4-854-3058
Email: r_eliakim@rambam.health.gov.il
