Introduction
Capsule endoscopy (CE) is a valuable, non-invasive diagnostic tool for the evaluation of small bowel disorders, particularly in patients with suspected inflammatory bowel disease (IBD), known Crohn’s disease, or non-responsive celiac disease (NRCD) (1). Its role in identifying mucosal lesions and guiding clinical decision-making continues to expand, especially in the context of complex or unclear gastrointestinal symptoms.
Aims & Methods
This observational, single-centre retrospective study included all CE procedures performed at the Department of Gastroenterology of the Azienda Ospedaliera–Università di Padova between January 1, 2018, and December 31, 2024. Indications for CE included suspected IBD (e.g., diarrhea, abdominal pain, elevated fecal calprotectin), follow-up of known ileal Crohn’s disease, and evaluation of NRCD. Demographic and clinical data were collected in a dedicated database. CE was considered positive if at least one of the following findings was present: evidence of recent bleeding, ulcers, or villous atrophy. Multivariate analyses were used to assess risk factors associated with ulcers and villous atrophy. Statistical analyses were conducted using STATA 18.
Results
A total of 351 CE procedures were included: 210 for suspected IBD, 108 for IBD follow-up, and 37 for NRCD. The mean age of the cohort was 45.7 ± 16.0 years, with 47% male patients. The diagnostic yield was 39.3% for suspected IBD, 44.4% for IBD follow-up, and 56.7% for NRCD. The prevalence of recent bleeding was similar across groups (31.1% vs. 27.4% vs. 31.6%, p=0.895), as was the presence of ulcers (65.3% vs. 62.1% vs. 40%, p=0.105). However, villous atrophy was significantly more frequent in NRCD patients (0% in suspected IBD, 2.3% in IBD, and 66.7% in NRCD; p<0.001). No association was found between lesions and age, sex, hemoglobin levels, or comorbidities. CE findings led to therapeutic changes in 37% of IBD cases and in 16% of NRCD cases.
Conclusion
This single-centre cohort study confirms the high diagnostic yield of capsule endoscopy in patients with small bowel disorders and highlights its impact on their clinical management.
References
1. Tamilarasan AG, Tran Y, Paramsothy S, Leong R. The diagnostic yield of pan-enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta-analysis. Journal of Gastroenterology and Hepatology (Australia). 2022 Dec 1;37(12):2207–16.