Editorial Current Status and Future Directions of Capsule ...
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Editorial Current Status and Future Directions of Capsule Endoscopy Hoon Jai Chun, 1 Satoshi Tanabe, 2 Myung-Gyu Choi, 3 and Jean-Christophe Saurin 4 1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, Republic of Korea 2 Division of erapeutic Endoscopy, Department of Advanced Medicine, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan 3 Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, e Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea 4 Edouard Herriot Hospital, Gastroenterology Unit, Pavillon L, 5 Place d’Arsonval, 69437 Lyon Cedex 03, France Correspondence should be addressed to Hoon Jai Chun; [email protected] Received 9 November 2015; Accepted 10 November 2015 Copyright © 2016 Hoon Jai Chun et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Small bowel capsule endoscopy (CE) is a method of endo- luminal examination of the small bowel using a wireless disposable capsule-shaped tool which is swallowed and then propelled by gut motility through the gastrointestinal tract. Since its first use more than 10 years ago, CE has been a first-line diagnostic method for the evaluation of the small bowel. e most common indications for CE include obscure gastrointestinal bleeding (OGIB), suspected Crohn’s disease, small bowel tumor, and polyposis syndrome. Up until now, the application of CE has been widened based on the results of many clinical studies. In the current special issue, issues other than OGIB, such as Crohn’s disease, ileitis, and portal-hypertensive enteropathy (PHE), have been focused on. However, CE has some limitations, such as inadequate bowel preparation and incompletion. To increase diagnosis yield, adequate bowel preparation and complete examination of the entire small bowel are important. And another important limitation of CE is the risk of retention. As one of the efforts to solve this problem, the real clinical experience with the PillCam patency capsule prior to CE was introduced. D.-H. Yang et al. have extensively reviewed the diagnostic accuracy and the therapeutic impact of CE in Crohn’s disease. However, clinical experience with CE for the diagnosis and management of Crohn’s disease is still limited despite the advantages of CE over other modalities. e risk of capsule retention, lack of evidence on the clinical benefit, and lack of established indications for CE in Crohn’s disease may limit the widespread use of CE in clinical practice for suspected or established Crohn’s disease. Ileitis is defined as inflammation of the ileum, and various etiologies are associated with ileitis. However, the differential diagnosis of terminal ileitis can be difficult in many cases. H. S. Lee and Y. J. Lim have described each of the various conditions associated with ileitis and the diagnostic value of CE for ileitis, which may help identify and evaluate these conditions in clinical practice. S. R. Jeon and J.-O. Kim have reviewed that CE has enabled the identification of PHE as a potentially significant complication of portal hypertension. In patients with liver cirrhosis and OGIB, PHE might be a possible cause for GI blood loss. CE can be a useful method for identifying treatable lesions in patients with PHE and can help optimize treatment on a case-by-case basis. Bowel preparation before CE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regard- ing different kinds of bowel cleansing agents in bowel prepa- ration for small bowel CE. H. J. Song et al. have reviewed previous studies regarding bowel preparation for small bowel CE and suggested optimal bowel preparation of VCE. C. R¨ ommele et al. have performed a retrospective analysis of 38 patients with risk factors for capsule retention and have indicated that CE could safely be performed even if the Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2016, Article ID 4159745, 2 pages http://dx.doi.org/10.1155/2016/4159745
Transcript of Editorial Current Status and Future Directions of Capsule ...
EditorialCurrent Status and Future Directions of Capsule Endoscopy
Hoon Jai Chun,1 Satoshi Tanabe,2 Myung-Gyu Choi,3 and Jean-Christophe Saurin4
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical InstrumentResearch, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, Republic of Korea2Division ofTherapeutic Endoscopy, Department of AdvancedMedicine, Research andDevelopment Center for NewMedical Frontiers,Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan3Division of Gastroenterology, Department of InternalMedicine, Seoul St.Mary’s Hospital, College ofMedicine,TheCatholic Universityof Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea4Edouard Herriot Hospital, Gastroenterology Unit, Pavillon L, 5 Place d’Arsonval, 69437 Lyon Cedex 03, France
Correspondence should be addressed to Hoon Jai Chun; [email protected]
Received 9 November 2015; Accepted 10 November 2015
Copyright © 2016 Hoon Jai Chun et al.This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Small bowel capsule endoscopy (CE) is a method of endo-luminal examination of the small bowel using a wirelessdisposable capsule-shaped tool which is swallowed and thenpropelled by gut motility through the gastrointestinal tract.Since its first use more than 10 years ago, CE has been afirst-line diagnostic method for the evaluation of the smallbowel.Themost common indications for CE include obscuregastrointestinal bleeding (OGIB), suspected Crohn’s disease,small bowel tumor, and polyposis syndrome. Up until now,the application of CE has been widened based on the resultsof many clinical studies.
In the current special issue, issues other than OGIB,such as Crohn’s disease, ileitis, and portal-hypertensiveenteropathy (PHE), have been focused on. However, CE hassome limitations, such as inadequate bowel preparation andincompletion. To increase diagnosis yield, adequate bowelpreparation and complete examination of the entire smallbowel are important. And another important limitation ofCE is the risk of retention. As one of the efforts to solvethis problem, the real clinical experience with the PillCampatency capsule prior to CE was introduced.
D.-H. Yang et al. have extensively reviewed the diagnosticaccuracy and the therapeutic impact of CE in Crohn’s disease.However, clinical experience with CE for the diagnosis andmanagement of Crohn’s disease is still limited despite theadvantages of CE over other modalities. The risk of capsuleretention, lack of evidence on the clinical benefit, and lack of
established indications for CE in Crohn’s disease may limitthe widespread use of CE in clinical practice for suspected orestablished Crohn’s disease.
Ileitis is defined as inflammation of the ileum, and variousetiologies are associated with ileitis. However, the differentialdiagnosis of terminal ileitis can be difficult in many cases.H. S. Lee and Y. J. Lim have described each of the variousconditions associated with ileitis and the diagnostic value ofCE for ileitis, which may help identify and evaluate theseconditions in clinical practice.
S. R. Jeon and J.-O. Kim have reviewed that CE hasenabled the identification of PHE as a potentially significantcomplication of portal hypertension. In patients with livercirrhosis and OGIB, PHE might be a possible cause for GIblood loss. CE can be a usefulmethod for identifying treatablelesions in patients with PHE and can help optimize treatmenton a case-by-case basis.
Bowel preparation before CE is as essential as bowelpreparation before colonoscopy. To date, there have beenmany comparative studies, consensus, and guidelines regard-ing different kinds of bowel cleansing agents in bowel prepa-ration for small bowel CE. H. J. Song et al. have reviewedprevious studies regarding bowel preparation for small bowelCE and suggested optimal bowel preparation of VCE.
C. Rommele et al. have performed a retrospective analysisof 38 patients with risk factors for capsule retention andhave indicated that CE could safely be performed even if the
Hindawi Publishing CorporationGastroenterology Research and PracticeVolume 2016, Article ID 4159745, 2 pageshttp://dx.doi.org/10.1155/2016/4159745
2 Gastroenterology Research and Practice
patency capsule excretion time is longer than 30 hours andthe excreted patency capsule was not screened for damage.
Acknowledgment
We would like to show our gratitude to Professor Ki-NamShim for her devotion to our special issue. Professor Ki-NamShim has contributed to this special issue from making theproposal and encouraging the submission of manuscripts toorganizing their process, and so forth. We are profoundlygrateful for her laborious task in this special issue.
Hoon Jai ChunSatoshi Tanabe
Myung-Gyu ChoiJean-Christophe Saurin
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