Letter to the Editor

Further Indications for Capsule Endoscopy

Authors: Oscar M. P. Jolobe, MRCP

Abstract

To the Editor:


In their excellent review from the April 2008 issue of the Southern Medical Journal, Sachdev and Ismail1 briefly allude to the possibility of a role for capsule endoscopy in the follow up of celiac disease. In the latter context, capsule endoscopy has proven useful in the evaluation of patients with known celiac disease who have ongoing symptoms or alarm symptoms in spite of compliance with a gluten-free diet. In a prospective study of 47 such patients, the indications for capsule endoscopy included abdominal pain, cancer surveillance, blood in the stool, or persistent iron deficiency. At capsule endoscopy, ulceration was diagnosed in 21 patients, and there were isolated instances of adenocarcinoma, polyps, strictures, and intussusception.

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References

1. Sachdev MS, Ismail MK. Capsule endoscopy: a review. South Med J 2008;101:407–414.
 
2. Culliford A, Daly J, Diamond B, et al. The value of wireless capsule endoscopy in patients with complicated celiac disease. Gastrointest Endosc 2005;62:55–61.
 
3. Sidhu R, Sanders DS, Morris AJ, et al. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut 2008;57:125–136.
 
4. Yang A, Chen Y, Scherl E, et al. Inflammatory bowel disease in patients with celiac disease. Inflamm Bowel Dis 2005;11:528–532.
 
5. de’angelis GL, Fornaroli F, de’Angelis N, et al. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenterol 2007;102:1749–1757; quiz 1748, 1758.