Small Bowel Video Capsule Endoscopy
In addition to current indications, VCE is explored as a diagnostic tool in other areas of gastroenterology. In IBD, VCE is already used in early diagnosis of small bowel Crohn's disease.
Its role in follow up of IBD and disease activity is evolving. Disease activity monitoring is likely to change from being symptom-based to the direct monitoring of mucosal healing through VCE; this depends on the VCE scores index and correlation with serum biochemical and fecal marker, radiology and endoscopy.
Since its introduction in 2001, the indications for VCE have changed, and it is likely that its use and application in clinical practice will continue to expand in the future. Other areas where VCE is investigated include GI food allergy and in ischemic intestinal disease due to mesenteric venous thrombosis. The endoscopic finding of this disease may appear as edema, ulcers with circumferential, 'snail track'-like or segmental appearance. These findings may occur during bleeding or the process of healing.
Aspects of VCE that can be enhanced in the future include more efficient and easier bowel preparation and shortening of the transit time. Moreover, other parts of the GI tract may be examined, such as the stomach or the colon, whereby CE may offer a more convenient procedure for indications, such as screening for polyps. Novel devices that can maneuver within or insufflate the bowel, tag or biopsy lesions, or deliver medications to specific locations are in development.
Advances in technology having small, more efficient batteries may allow more sophisticated hardware to be housed in a smaller diagnostic capsule. This in turn may achieve more diagnostic and even therapeutic goals.
Five-year View
In addition to current indications, VCE is explored as a diagnostic tool in other areas of gastroenterology. In IBD, VCE is already used in early diagnosis of small bowel Crohn's disease.
Its role in follow up of IBD and disease activity is evolving. Disease activity monitoring is likely to change from being symptom-based to the direct monitoring of mucosal healing through VCE; this depends on the VCE scores index and correlation with serum biochemical and fecal marker, radiology and endoscopy.
Since its introduction in 2001, the indications for VCE have changed, and it is likely that its use and application in clinical practice will continue to expand in the future. Other areas where VCE is investigated include GI food allergy and in ischemic intestinal disease due to mesenteric venous thrombosis. The endoscopic finding of this disease may appear as edema, ulcers with circumferential, 'snail track'-like or segmental appearance. These findings may occur during bleeding or the process of healing.
Aspects of VCE that can be enhanced in the future include more efficient and easier bowel preparation and shortening of the transit time. Moreover, other parts of the GI tract may be examined, such as the stomach or the colon, whereby CE may offer a more convenient procedure for indications, such as screening for polyps. Novel devices that can maneuver within or insufflate the bowel, tag or biopsy lesions, or deliver medications to specific locations are in development.
Advances in technology having small, more efficient batteries may allow more sophisticated hardware to be housed in a smaller diagnostic capsule. This in turn may achieve more diagnostic and even therapeutic goals.