Categories: Crohn's Disease, Endoscopy

May 2009 Volume 5, Issue 5

Glen A. Doherty, MD, PhD, and Adam S. Cheifetz, MD

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Clinicians currently have access to an expanding range of diagnostic modalities for assessment of the small intestine when diagnosing or evaluating the extent of Crohn’s disease. Although complete endoscopic examination of the colon with a standard videoendoscope is routine, endoscopic assessment of the entire small intestine by enteroscopy is not feasible as a routine diagnostic test. Capsule endoscopy (CE) has gained increasing acceptance as a highly sensitive small bowel imaging modality, though concerns have been raised regarding the risk of false-positive examinations and complications arising from capsule retention proximal to stenotic lesions. This review will examine current data on the utility of CE in suspected and established Crohn’s disease in comparison to other modalities such as push enteroscopy, computed tomography, magnetic resonance enterography, and small bowel follow-through. Current suggested indications for CE in patients with known or suspected Crohn’s disease will be evaluated in order to offer a potential framework for the safe and appropriate use of capsule examinations in these patients.