Colon capsule endoscopy

PillCam colon capsule endoscopy (CCE) (Covidien, USA, formerly Given Imaging, Yoqneam, Israel) is a noninvasive technique that enables endoscopic evaluation of the colon without sedation, ionizing radiation, or air insufflation. Recently, a new generation of colon capsule was included in the portfolio of capsule endoscopy. The new generation of CCE was demonstrated to be accurate to detect colonic lesions, such as polyps and tumors. To date, CCE is not an alternative to screening colonoscopy. It is a complementary test for average-risk patients unwilling to undergo optical colonoscopy, in case of incomplete colonoscopy, or in case of patients unable to safely undergo optical colonoscopy. In the United States, it is approved by the Food and Drug Administration only for incomplete colonoscopy owing to technical reasons. CCE has been also cleared by Japan’s Pharmaceuticals & Medical Devices Agency (PMDA) for diagnosis of colonic disease when colonoscopy is required but difficult to conduct, including patients unwilling or unable to undergo colonoscopy. Other potential applications of CCE, such as in colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease (IBD), remain to be clarified.