The role of capsule endoscopy in evaluating both suspected and known Crohnʼs disease

Capsule endoscopy (CE) has revolutionized our approach to evaluating the small bowel. The capsule endoscope is an ingestible and disposable video camera that transmits high-quality images of the small bowel mucosa. Conferring the ability to visualize the entire small bowel, CE has the potential to facilitate the evaluation of Crohnʼs disease (CD), providing access to bowel segments previously inaccessible by push enteroscopy and ileocolonoscopy. CE appears to be complementary to cross-sectional imaging techniques such as computed tomography and magnetic resonance enterography and has demonstrated comparable yields in patients with CD. In addition to facilitating diagnosis of CD, CE also has the ability to document mucosal healing in response to treatment in established CD and has proven instrumental in further categorizing patients diagnosed with inflammatory bowel disease unspecified. As a noninvasive test, CE holds particular promise in the evaluation of pediatric inflammatory bowel disease. Although the risk of capsule retention remains a concern in patients with stricturing disease, CE is considered safe in most patients.