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Novel Imaging Enhancements in Capsule Endoscopy

DOI: 10.1155/2013/304723

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Abstract:

Video capsule endoscopy that was launched 10 years ago has become a first-line procedure for examining the small bowel. The most common indications for capsule endoscopy are obscure gastrointestinal bleeding, Crohn's disease, polyposis syndromes, and evaluation of patients with complicated celiac disease. The ideal capsule should improve the quality of the image and have a faster frame rate than the currently available one. There should be a therapeutic capsule capable of performing a biopsy, aspirating fluid, delivering drugs, and measuring the motility of the small bowel wall. Another major leap forward would be the capability of remote control of capsule's movement in order to navigate it to reach designated anatomical areas for carrying out a variety of therapeutic options. Technology for improving the capability of the future generation capsules almost within grasp and it would not be surprising to witness the realization of these giant steps within the coming decade. In this review we will focus on the current clinical applications of capsule endoscopy for imaging of the small bowel and colon and will additionally give an outlook on future concepts and developments of capsule endoscopy. 1. Introduction Small bowel capsule endoscopy (SBCE) was introduced 13 years ago. To date, multiple CE systems from different companies are available. Currently the Given M2A Video Capsule System (Given Imaging Ltd., Yokneam, Israel), the Olympus EndoCapsule (Olympus, Tokyo, Japan), and the MiroCam (Intromedic, Seoul, Korea) are FDA and CE approved. Capsule systems are available for examination of the esophagus, small bowel, and colon. Capsule endoscopy is easily ingested and swallowed by most individuals, but also, a capsule-loading device (AdvanCE, US Endoscopy, Mentor, OH, USA) is available to directly deliver the capsule into the stomach or duodenum. The disposable device is a 2.5?mm single-sheathed device that is first preloaded through the working channel of a standard endoscope. The main indications for SBCE include obscure GI bleeding, Crohn’s disease, and celiac disease [1]. 2. Patient Preparation There are several accepted preparation methods for SBCE for small bowel CE, which include fasting since the day before, clear liquid diet, the ingestion of 2–4 liters of polyethylene glycol solution. In addition, some experts recommend the use of simethicone before the ingestion of the capsule to reduce intraluminal foam and bubbles [2]. 3. Indications 3.1. Obscure Gastrointestinal Bleeding Many reports have shown a statistically significant increased diagnostic

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