Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

 

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Crohn’s disease and ulcerative colitis are lifelong diseases seen predominantly in the developed countries of the world.

Whereas ulcerative colitis is a chronic inflammatory condition causing diffuse and continuous mucosal inflammation of the colon, Crohn’s disease is a heterogeneous entity comprised of several different phenotypes, but can affect the entire gastrointestinal tract. A change in diagnosis from Crohn’s disease to ulcerative colitis during the first year of illness occurs in about 10 % – 15 % of cases. Inflammatory bowel disease (IBD) restricted to the colon that cannot be characterized as either ulcerative colitis or Crohn’s disease is termed IBD-unclassified (IBDU).

The advent of capsule and both single- and double-balloon-assisted enteroscopy is revolutionizing small-bowel imaging and has major implications for diagnosis, classification, therapeutic decision making and outcomes in the management of IBD. The role of these investigations in the diagnosis and management of IBD, however, is unclear.

This document sets out the current Consensus reached by a group of international experts in the fields of endoscopy and IBD at a meeting held in Brussels, 12–13th December 2008, organised jointly by the European Crohn’s and Colitis Organisation (ECCO) and the Organisation Mondiale d’Endoscopie Digestive (OMED). The Consensus is grouped into seven sections: definitions and diagnosis; suspected Crohn’s disease; established Crohn’s disease; IBDU; ulcerative colitis (including ileal pouch–anal anastomosis [IPAA]); paediatric practice; and complications and unresolved questions.

Consensus guideline statements are followed by comments on the evidence and opinion. Statements are intended to be read in context with qualifying comments and not read in isolation.

References

• 1 Shivananda S, Lennard-Jones J, Logan R. et al . Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD).  Gut. 1996;  39 690-697
  CrossrefPubMedGoogle Scholar
• 2 Silverberg M, Satsangi J, Ahmad T. et al . Toward an integrated clinical molecular and serological classification of inflammatory bowel disease: report of a working party of the Montreal World Congress of Gastroenterology.  Can J Gastroenterol. 2005;  19 (Suppl A) 5A-36A
  PubMedGoogle Scholar
• 3 Strange E F, Travis S PL, Vermeire S. et al . European evidence-based Consensus on the diagnosis and management of ulcerative colitis:Definitions and diagnosis.  J Crohn’s Colitis. 2007;  2 22
  PubMedGoogle Scholar
• 4 Stange E F, Travis S, Vermeire S. et al . European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis.  Gut. 2006;  55 (Suppl 1) i1-i15
  CrossrefPubMedGoogle Scholar
• 5 Fink A, Kosecoff J, Chassin M, Brook R H. Consensus methods: characteristics and guidelines for use.  Am J Public Health. 1984;  74 979-983
  CrossrefPubMedGoogle Scholar
• 6 Centre for Evidence Based Medicine , Oxford .Levels of evidence and grades of recommendation. Available at: http://www.cebm.net/levels_of_evidence.asp
  Google Scholar
• 7 Lin O S, Brandabur J J, Schembre D B. et al . Acute symptomatic small bowel obstruction due to capsule impaction.  Gastrointest Endosc. 2007;  65 725-728
  CrossrefPubMedGoogle Scholar
• 8 Carey E J, Leighton J A, Heigh R I. et al . A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding.  Am J Gastroenterol. 2007;  102 89-95
  CrossrefPubMedGoogle Scholar
• 9 Pennazio M, Arrigoni A, Risio M. et al . Clinical evaluation of push-type enteroscopy.  Endoscopy. 1995;  27 164-170
  PubMedGoogle Scholar
• 10 Yamamoto H, Sekine Y, Sato Y. et al . Total enteroscopy with a nonsurgical steerable double-balloon method.  Gastrointest Endosc. 2001;  53 216-220
  Google Scholar
• 11 Tsujikawa T, Saitoh Y, Andoh A. et al . Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences.  Endoscopy. 2008;  40 11-15
  Article in Thieme ConnectPubMedGoogle Scholar
• 12 Hotokezaka M, Jimi S I, Hidaka H. et al . Role of intraoperative enteroscopy for surgical decision making with Crohn’s disease.  Surg Endosc. 2007;  21 1238-1242
  CrossrefPubMedGoogle Scholar
• 13 Hotokezaka M, Jimi S, Hidaka H. et al . Intraoperative enteroscopy in minimally invasive surgery.  Surg Laparosc Endosc Percutan Tech. 2007;  17 492-494
  CrossrefPubMedGoogle Scholar
• 14 Klein O, Colombel J F, Lescut D. et al . Remaining small bowel endoscopic lesions at surgery have no influence on early anastomotic recurrences in Crohn’s disease.  Am J Gastroenterol. 1995;  90 1949-1952
  PubMedGoogle Scholar
• 15 Akerman P A, Agrawal D, Cantero D, Pangtay J. Spiral enteroscopy with the new DSB overtube: a novel technique for deep peroral small-bowel intubation.  Endoscopy. 2008;  40 974-978
  Article in Thieme ConnectPubMedGoogle Scholar
• 16 Akerman P A, Agrawal D, Chen W. et al . Spiral enteroscopy: a novel method of enteroscopy by using the Endo-Ease Discovery SB overtube and a pediatric colonoscope.  Gastrointest Endosc. 2009;  69 327-332
  CrossrefPubMedGoogle Scholar
• 17 Molinie F, Gower-Rousseau C, Yzet T. et al . Opposite evolution in incidence of Crohn’s disease and ulcerative colitis in Northern France (1988–1999).  Gut. 2004;  53 843-848
  CrossrefPubMedGoogle Scholar
• 18 Lashner B. Clinical features, laboratory findings, and course of Crohn’s disease. In: Kirsner JV (ed) Inflammatory bowel disease. 5th edn. Philadelphia; Saunders 2000: 305-314
  Google Scholar
• 19 Mow W S, Lo S K, Targan S R. et al . Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease.  Clin Gastroenterol Hepatol. 2004;  2 31-40
  CrossrefPubMedGoogle Scholar
• 20 Hara A K, Leighton J A, Heigh R I. et al . Crohn disease of the small bowel: preliminary comparison among CT enterography, capsule endoscopy, small-bowel follow-through, and ileoscopy.  Radiology. 2006;  238 128-134
  CrossrefPubMedGoogle Scholar
• 21 Solem C A, Loftus Jr E V, Fletcher J G. et al . Small-bowel imaging in Crohn’s disease: a prospective, blinded, 4-way comparison trial.  Gastrointest Endosc. 2008;  68 255-266
  CrossrefPubMedGoogle Scholar
• 22 Voderholzer W A, Beinhoelzl J, Rogalla P. et al . Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis.  Gut. 2005;  54 369-373
  CrossrefPubMedGoogle Scholar
• 23 Dubcenco E, Jeejeebhoy K N, Petroniene R. et al . Capsule endoscopy findings in patients with established and suspected small-bowel Crohn’s disease: correlation with radiologic, endoscopic, and histologic findings.  Gastrointest Endosc. 2005;  62 538-544
  CrossrefPubMedGoogle Scholar
• 24 Chong A K, Taylor A, Miller A. et al . Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn’s disease.  Gastrointest Endosc. 2005;  61 255-261
  CrossrefPubMedGoogle Scholar
• 25 Golder S K, Schreyer A G, Endlicher E. et al . Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease.  Int J Colorectal Dis. 2006;  21 97-104
  CrossrefPubMedGoogle Scholar
• 26 Marmo R, Rotondano G, Piscopo R. et al . Capsule endoscopy versus enteroclysis in the detection of small-bowel involvement in Crohn’s disease: a prospective trial.  Clin Gastroenterol Hepatol. 2005;  3 772-776
  CrossrefPubMedGoogle Scholar
• 27 Rokkas T, Papaxoinis K, Triantafyllou K. et al . Does purgative preparation influence the diagnostic yield of small bowel video capsule endoscopy? A meta-analysis.  Am J Gastroenterol. 2009;  104 219-227
  CrossrefPubMedGoogle Scholar
• 28 Sidhu R, Sanders D S, Morris A J, McAlindon M E. Guidelines on small bowel enteroscopy and capsule endoscopy in adults.  Gut. 2008;  57 125-136
  CrossrefPubMedGoogle Scholar
• 29 Graham D Y, Opekun A R, Willingham F F, Qureshi W A. Visible small-intestinal mucosal injury in chronic NSAID users.  Clin Gastroenterol Hepatol. 2005;  3 55-59
  CrossrefPubMedGoogle Scholar
• 30 Maiden L, Thjodleifsson B, Seigal A. et al . Long-term effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective agents on the small bowel: a cross-sectional capsule enteroscopy study.  Clin Gastroenterol Hepatol. 2007;  5 1040-1045
  CrossrefPubMedGoogle Scholar
• 31 Hawkey C J, Ell C, Simon B. et al . Less small-bowel injury with lumiracoxib compared with naproxen plus omeprazole.  Clin Gastroenterol Hepatol. 2008;  6 536-544
  CrossrefPubMedGoogle Scholar
• 32 Mary J Y, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn’s disease: a prospective multicentre study. Groupe d’Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID).  Gut. 1989;  30 983-989
  PubMedGoogle Scholar
• 33 Daperno M, D’Haens G, Van Assche G. et al . Development and validation of a new, simplified endoscopic activity score for Crohn’s disease: the SES-Crohn’s Disease.  Gastrointest Endosc. 2004;  60 505-512
  CrossrefPubMedGoogle Scholar
• 34 Rutgeerts P, Geboes K, Vantrappen G. et al . Predictability of the postoperative course of Crohn’s disease.  Gastroenterology. 1990;  99 956-963
  PubMedGoogle Scholar
• 35 Gralnek I M, Defranchis R, Seidman E. et al . Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change.  Aliment Pharmacol Ther. 2008;  27 146-154
  CrossrefPubMedGoogle Scholar
• 36 Gal E, Geller A, Fraser G. et al . Assessment and validation of the new Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI).  Dig Dis Sci. 2008;  53 1933-1937
  CrossrefPubMedGoogle Scholar
• 37 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease.  Gastroenterology. 2002;  123 999-1005
  CrossrefPubMedGoogle Scholar
• 38 Toth E, Fork F-T, Almqvist P. et al . Wireless capsule endoscopy: a comparison with enterography, push enteroscopy and ileocolonoscopy in the diagnosis of small bowel Crohn’s disease [abstract].  Gastrointest Endosc. 2004;  59 P173
  PubMedGoogle Scholar
• 39 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease.  Eur J Gastroenterol Hepatol. 2003;  15 363-367
  Google Scholar
• 40 Marmo R, Rotondano G, Piscopo R. et al . Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases.  Aliment Pharmacol Ther. 2005;  22 595-604
  CrossrefPubMedGoogle Scholar
• 41 Apostolopoulos P, Giannakoulopoulou E, Papanikolaou I. et al . M2A wireless capsule endoscopy versus enteroclysis: A prospective study in 68 patients with suspected small bowel disease [abstract].  Gastrointest Endosc. 2004;  59 P147
  PubMedGoogle Scholar
• 42 Liangpunsakul S, Chadalawada V, Rex D K. et al . Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis.  Am J Gastroenterol. 2003;  98 1295-1298
  CrossrefPubMedGoogle Scholar
• 43 Triester S L, Leighton J A, Leontiadis G I. et al . A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease.  Am J Gastroenterol. 2006;  101 954-964
  CrossrefPubMedGoogle Scholar
• 44 Albert J G, Martiny F, Krummenerl A. et al . Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis.  Gut. 2005;  54 1721-1727
  CrossrefPubMedGoogle Scholar
• 45 Voderholzer W A, Ortner M, Rogalla P. et al . Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis.  Endoscopy. 2003;  35 1009-1014
  Article in Thieme ConnectPubMedGoogle Scholar
• 46 Chang D K, Kim J J, Choi H. et al . Double balloon endoscopy in small intestinal Crohn’s disease and other inflammatory diseases such as cryptogenic multifocal ulcerous stenosing enteritis (CMUSE).  Gastrointest Endosc. 2007;  66 S96-S98
  CrossrefPubMedGoogle Scholar
• 47 Heine G D, Hadithi M, Groenen M J. et al . Double-balloon enteroscopy: indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease.  Endoscopy. 2006;  38 42-48
  Article in Thieme ConnectPubMedGoogle Scholar
• 48 Gay G, Delvaux M. Double balloon enteroscopy in Crohn’s disease and related disorders: our experience.  Gastrointest Endosc. 2007;  66 S82-90
  CrossrefPubMedGoogle Scholar
• 49 Seiderer J, Herrmann K, Diepolder H. et al . Double-balloon enteroscopy versus magnetic resonance enteroclysis in diagnosing suspected small-bowel Crohn’s disease: results of a pilot study.  Scand J Gastroenterol. 2007;  42 1376-1385
  CrossrefPubMedGoogle Scholar
• 50 Cazzato I A, Cammarota G, Nista E C. et al . Diagnostic and therapeutic impact of double-balloon enteroscopy (DBE) in a series of 100 patients with suspected small bowel diseases.  Dig Liver Dis. 2007;  39 483-487
  CrossrefPubMedGoogle Scholar
• 51 Pennazio M, Sprujevnik T, Arrigoni A. et al . Outcome of double-balloon enteroscopy after capsule endoscopy in patients with suspected small-bowel disease [abstract].  Gastrointest Endosc. 2006;  63 AB90
  PubMedGoogle Scholar
• 52 Lo S K, Ross A A, Leighton J A. et al . Double balloon enteroscopy: An initial multicenter U.S. experience.  Am J Gastroenterol. 2005;  100 S103
  CrossrefPubMedGoogle Scholar
• 53 Jo J, Byeon J, Choi K. et al . Comparison of double balloon enteroscopy and small bowel series for the evaluation of small bowel lesions.  Korean J Gastroenterol. 2006;  48 55-57
  PubMedGoogle Scholar
• 54 Benz C, Jakobs R, Riemann J F. Do we need the overtube for push-enteroscopy?.  Endoscopy. 2001;  33 658-661
  Google Scholar
• 55 Foutch P G, Sawyer R, Sanowski R A. Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure origin.  Gastrointest Endosc. 1990;  36 337-341
  PubMedGoogle Scholar
• 56 Ogoshi K, Hara Y, Ashizawa S. New technic for small intestinal fiberoscopy.  Gastrointest Endosc. 1973;  20 64-65
  CrossrefPubMedGoogle Scholar
• 57 Appleyard M, Fireman Z, Glukhovsky A. et al . A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions.  Gastroenterology. 2000;  119 1431-1438
  CrossrefPubMedGoogle Scholar
• 58 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy.  Nature. 2000;  405 417
  PubMedGoogle Scholar
• 59 May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease.  Gastrointest Endosc. 2005;  62 62-70
  CrossrefPubMedGoogle Scholar
• 60 Pohl J, May A, Nachbar L, Ell C. Diagnostic and therapeutic yield of push-and-pull enteroscopy for symptomatic small bowel Crohn’s disease strictures.  Eur J Gastroenterol Hepatol. 2007;  19 529-534
  CrossrefPubMedGoogle Scholar
• 61 Rossini F P, Pennazio M. Small-bowel endoscopy.  Endoscopy. 2002;  34 13-20
  Article in Thieme ConnectPubMedGoogle Scholar
• 62 Yamamoto H, Yano T, Kita H. et al . New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders.  Gastroenterology. 2003;  125 1556-1557
  PubMedGoogle Scholar
• 63 Manno M, Mussetto A, Conigliaro R. Preliminary results of alternative „simultaneous” technique for single-balloon enteroscopy.  Endoscopy. 2008;  40 538
  Article in Thieme ConnectPubMedGoogle Scholar
• 64 Herrerias J M, Leighton J A, Costamagna G. et al . Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy.  Gastrointest Endosc. 2008;  67 902-909
  CrossrefPubMedGoogle Scholar
• 65 Saurin J C, Maunoury V, Lapalus M G. et al . International consensus in Paris, 2006, on the indications and use of the endoscopic videocapsule test. Report of the SFED capsule commission.  Gastroenterol Clin Biol. 2007;  31 798-805
  CrossrefPubMedGoogle Scholar
• 66 Postgate A J, Burling D, Gupta A. et al . Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: A 3-year technical review.  Dig Dis Sci. 2008;  53 2732-2738
  CrossrefPubMedGoogle Scholar
• 67 Eliakim R, Suissa A, Yassin K. et al . Wireless capsule video endoscopy compared to barium follow-through and computerised tomography in patients with suspected Crohn’s disease – final report.  Dig Liver Dis. 2004;  36 519-522
  CrossrefPubMedGoogle Scholar
• 68 Rajesh A, Sandrasegaran K, Jennings S G. et al . Comparison of capsule endoscopy with enteroclysis in the investigation of small bowel disease.  Abdom Imaging. 2008;  June 11 [epub ahead of print]
  PubMedGoogle Scholar
• 69 Tillack C, Seiderer J, Brand S. et al . Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoscopy (CE) in the diagnosis of small bowel lesions in Crohn’s disease.  Inflamm Bowel Dis. 2008;  14 1219-1228
  CrossrefPubMedGoogle Scholar
• 70 Olaison G, Smedh K, Sjodahl R. Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms.  Gut. 1992;  33 331-335
  CrossrefPubMedGoogle Scholar
• 71 Bourreille A, Jarry M, D’Halluin P N. et al . Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn’s disease: a prospective study.  Gut. 2006;  55 978-982
  CrossrefPubMedGoogle Scholar
• 72 Pons B eltran, Nos P, Bastida G. et al . Evaluation of postsurgical recurrence in Crohn’s disease: a new indication for capsule endoscopy?.  Gastrointest Endosc. 2007;  66 533-540
  CrossrefPubMedGoogle Scholar
• 73 Efthymiou A, Viazis N, Mantzaris G. et al . Does clinical response correlate with mucosal healing in patients with Crohn’s disease of the small bowel? A prospective, case-series study using wireless capsule endoscopy.  Inflamm Bowel Dis. 2008;  14 1542-1547
  CrossrefPubMedGoogle Scholar
• 74 Oshitani N, Yukawa T, Yamagami H. et al . Evaluation of deep small bowel involvement by double-balloon enteroscopy in Crohn’s disease.  Am J Gastroenterol. 2006;  101 1484-1489
  CrossrefPubMedGoogle Scholar
• 75 Choi H, Choi K Y, Eun C S. et al . Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study.  Gastrointest Endosc. 2007;  66 S22-S25
  CrossrefPubMedGoogle Scholar
• 76 Despott E J, Tripoli E, Polecina A. et al . Double balloon enteroscopy: A leap forward in the management of small bowel Crohn’s strictures.  Gastrointest Endosc. 2008;  67 AB273
  PubMedGoogle Scholar
• 77 May A, Nachbar L, Ell C. Extraction of entrapped capsules from the small bowel by means of push-and-pull enteroscopy with the double-balloon technique.  Endoscopy. 2005;  37 591-593
  Article in Thieme ConnectPubMedGoogle Scholar
• 78 Keuchel M. Double balloon (push-and-pull) enteroscopy: breakthrough in the management of small intestinal strictures in Crohn’s disease?.  Eur J Gastroenterol Hepatol. 2007;  19 523-525
  CrossrefPubMedGoogle Scholar
• 79 Sunada K, Yamamoto H, Kita H. et al . Balloon dilatation of small-intestinal benign strictures using double-balloon endoscopy.  Gastrointest Endosc. 2005;  61 AB183
  PubMedGoogle Scholar
• 80 Sunada K, Yamamoto H, Kita H. et al . Endoscopic balloon dilation therapy for small intestinal strictures with Crohn’s disease using double balloon endoscopy.  Gastrointest Endosc. 2007;  65 AB91
  PubMedGoogle Scholar
• 81 Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy.  Endoscopy. 2006;  38 49-58
  Article in Thieme ConnectPubMedGoogle Scholar
• 82 Mehdizadeh S, Han N J, Cheng D W. et al . Success rate of retrograde double-balloon enteroscopy.  Gastrointest Endosc. 2007;  65 633-639
  CrossrefPubMedGoogle Scholar
• 83 Mehdizadeh S, Ross A, Gerson L. et al . What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 US tertiary care centers.  Gastrointest Endosc. 2006;  64 740-750
  CrossrefPubMedGoogle Scholar
• 84 Gerson L, Chiorean M, Tokar J. et al . Complications associated with double balloon enteroscopy: the US experience.  Am J Gastroenterol. 2008;  103 S109-S110
  PubMedGoogle Scholar
• 85 Di Caro S, May A, Heine D GN. et al . The European experience with double-balloon enteroscopy: indications, methodology, safety, and clinical impact.  Gastrointest Endosc. 2005;  62 545-550
  CrossrefPubMedGoogle Scholar
• 86 Pasha S F, Leighton J A, Das A. et al . Double-balloon enteroscopy and capsule endoscopy have comparable diagnostic yield in small-bowel disease: a meta-analysis.  Clin Gastroenterol Hepatol. 2008;  6 671-676
  CrossrefPubMedGoogle Scholar
• 87 Vind I, Riis L, Jess T. et al . Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database.  Am J Gastroenterol. 2006;  101 1274-1282
  CrossrefPubMedGoogle Scholar
• 88 Stewenius J, Adnerhill I, Ekelund G. et al . Ulcerative colitis and indeterminate colitis in the city of Malmo, Sweden. A 25-year incidence study.  Scand J Gastroenterol. 1995;  30 38-43
  PubMedGoogle Scholar
• 89 Price A B. Overlap in the spectrum of non-specific inflammatory bowel disease – „colitis indeterminate”.  J Clin Pathol. 1978;  31 10
  PubMedGoogle Scholar
• 90 Geboes K, Colombel J F, Greenstein A. et al . Indeterminate colitis: a review of the concept – what’s in a name?.  Inflamm Bowel Dis. 2008;  14 850-857
  CrossrefPubMedGoogle Scholar
• 91 Satsangi J, Silverberg M S, Vermeire S, Colombel J F. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications.  Gut. 2006;  55 749-753
  CrossrefPubMedGoogle Scholar
• 92 Maunoury V, Sovoye G, Bourreille A. et al . Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified).  Inflamm Bowel Dis. 2007;  13 152-155
  CrossrefPubMedGoogle Scholar
• 93 Mehdizadeh S, Chen G, Enayati P J. et al . Diagnostic yield of capsule endoscopy in ulcerative colitis and inflammatory bowel disease of unclassified type (IBDU).  Endoscopy. 2008;  40 30-35
  Article in Thieme ConnectPubMedGoogle Scholar
• 94 Lo S, Zaidel O, Tabibzadef S. Utility of wireless capsule endoscopy (WCE) and IBD serology in re-classifying indeterminate colitis (IC).  Gastroenterology. 2003;  124 S1310
  PubMedGoogle Scholar
• 95 Hume G, Whitaker D, Radford-Smith G. et al .Can capsule endoscopy (CE) help diffrentiate the aetiology of indeterminate colitis (IC)? Proceedings of the 3rd International Conference on Capsule Endoscopy, Miami, Florida, 2004 : 38A. 
  Google Scholar
• 96 Mascaranhas-Saraiva , Baldaque-Silva F, Villas-Boas G. et al .Capsule endoscopy: a valuable help for the differential diagnosis of indeterminate colitis? Proceedings of the 4th International Conference on Capsule Endoscopy, Miami, Florida, USA, 2005. 
  Google Scholar
• 97 Llach L, Mata A, Pellise M. et al .The role of capsule endoscopy in patients with indeterminate colitis. Preliminary results of a prospective trial. Proceedings of the 5th International Conference on Capsule Endoscopy, Paris, 2006. 
  Google Scholar
• 98 Erber J, Erber W, Harwayne-Gidansky I. et al . Capsule endoscopy in patients with suspected and known Crohn’s disease: correlation with IBD serology [abstract].  Am J Gastroenterol. 2006;  101 S452
  PubMedGoogle Scholar
• 99 Galter S, Gonzales B, Montfort D. et al . Usefulness of capsule endoscopy in the study of the inflammatory bowel disease: preliminary results [abstract].  Gastroenterology. 2006;  130 A478
  PubMedGoogle Scholar
• 100 Santos S, Erber J, Legnani P. et al . Capsule endoscopy in patients with known IBD: frequency of findings, and influence on medical and surgical management are based upon indications for CE [abstract].  Am J Gastroenterol. 2006;  101 S462
  PubMedGoogle Scholar
• 101 Viazis N, Karamanolis D G. Indeterminate colitis – the role of wireless capsule endoscopy.  Aliment Pharmacol Ther. 2007;  25 859; author reply 860
  PubMedGoogle Scholar
• 102 Joossens S, Reinisch W, Vermeire S. et al . The value of serologic markers in indeterminate colitis: a prospective follow-up study.  Gastroenterology. 2002;  122 1242-1247
  CrossrefPubMedGoogle Scholar
• 103 Henriksen M, Jahnsen J, Lygren I. et al . Change of diagnosis during the first five years after onset of inflammatory bowel disease: results of a prospective follow-up study (the IBSEN Study).  Scand J Gastroenterol. 2006;  41 1037-1043
  CrossrefPubMedGoogle Scholar
• 104 Moum B, Vatn M H, Ekbom A. et al . Incidence of ulcerative colitis and indeterminate colitis in four counties of southeastern Norway, 1990–93. A prospective population-based study. The Inflammatory Bowel South-Eastern Norway (IBSEN) Study Group of Gastroenterologists.  Scand J Gastroenterol. 1996;  31 362-366
  CrossrefPubMedGoogle Scholar
• 105 Schluender S, Mehdizadeh S, Vasiliaukas A. et al . Does preoperative wireless endoscopic capsule predict long-term outcome after ileal pouch–anal anastomosis (IPAA)? [abstract].  Gastroenterology. 2006;  130 A214
  CrossrefPubMedGoogle Scholar
• 106 Shen B, Remzi F H, Santisi J. et al . Application of wireless capsule endoscopy for the evaluation of iron deficiency anemia in patients with ileal pouches.  J Clin Gastroenterol. 2008;  42 897-902
  CrossrefPubMedGoogle Scholar
• 107 Calabrese C, Fabbri A, Gionchetti P. et al . Controlled study using wireless capsule endoscopy for the evaluation of the small intestine in chronic refractory pouchitis.  Aliment Pharmacol Ther. 2007;  25 1311-1316
  CrossrefPubMedGoogle Scholar
• 108 Guilhon De Araujo Sant’Anna A M, Dubois J. et al . Wireless capsule endoscopy for obscure small-bowel disorders: Final results of the first pediatric controlled trial.  Clin Gastroenterol Hepatol. 2005;  3 264-270
  CrossrefPubMedGoogle Scholar
• 109 Rey J F, Ladas S, Alhassani A, Kuznetsov K. ESGE Guidelines Committee. European Society of Gastrointestinal Endoscopy (ESGE).  Video capsule endoscopy: update to guidelines (May 2006). 2006;  38 1047-1063
  Article in Thieme ConnectPubMedGoogle Scholar
• 110 Lee K, Anderson M. ASGE Standards of Practice Committee . Modifications in endoscopic practice for pediatric patients.  Gastrointest Endosc. 2008;  67 1-9
  CrossrefPubMedGoogle Scholar
• 111 De Angelis G L, Fornaroli F, De Angelis N. et al . Wireless capsule endoscopy for pediatric small-bowel diseases.  Am J Gastroenterol. 2007;  102 1749-1757
  CrossrefPubMedGoogle Scholar
• 112 Cohen S A, Gralnek I M, Ephrath H. et al . Capsule endoscopy may reclassify pediatric inflammatory bowel disease: a historical analysis.  J Pediatr Gastroenterol Nutr. 2008;  47 31-36
  CrossrefPubMedGoogle Scholar
• 113 Urbain D, Tresinie M, De Looze D. et al . Capsule endoscopy in paediatrics: Multicentric Belgian study.  Acta Gastroenterol Belg. 2007;  70 11-14
  PubMedGoogle Scholar
• 114 Thomson M, Fritscher-Ravens A, Mylonaki M. et al . Wireless capsule endoscopy in children: A study to assess diagnostic yield in small bowel disease in paediatric patients.  J Pediatr Gastroenterol Nutr. 2007;  44 192-197
  CrossrefPubMedGoogle Scholar
• 115 Moy L, Levine J. Wireless capsule endoscopy in the pediatric age group: Experience and complications.  J Pediatr Gastroenterol Nutr. 2007;  44 516-520
  CrossrefPubMedGoogle Scholar
• 116 Antao B, Bishop J, Shawis R, Thomson M. Clinical application and diagnostic yield of wireless capsule endoscopy in children.  J Laparoendosc Adv Surg Tech A. 2007;  17 364-370
  CrossrefPubMedGoogle Scholar
• 117 Arguelles-Arias F, Caunedo A, Romero J. et al . The value of capsule endoscopy in pediatric patients with a suspicion of Crohn’s disease.  Endoscopy. 2004;  36 869-873
  Article in Thieme ConnectPubMedGoogle Scholar
• 118 Ge Z Z, Chen H Y, Gao Y J. et al . Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases.  Eur J Pediatrics. 2007;  166 825-829
  CrossrefPubMedGoogle Scholar
• 119 Shamir R, Hino B, Hartman C. et al . Wireless video capsule in pediatric patients with functional abdominal pain.  J Pediatr Gastroenterol Nutr. 2007;  44 45-50
  CrossrefPubMedGoogle Scholar
• 120 Carvalho R S, Abadom V, Dilworth H P. et al . Indeterminate colitis: a significant subgroup of pediatric IBD.  Inflamm Bowel Dis. 2006;  12 258-262
  CrossrefPubMedGoogle Scholar
• 121 Kurugoglu S, Korman U, Adaletli I, Selcuk D. Enteroclysis in older children and teenagers.  Pediatr Radiol. 2007;  37 457-466
  CrossrefPubMedGoogle Scholar
• 122 Baath L, Ekberg O, Borulf S. et al . Small bowel barium examination in children. Diagnostic accuracy and clinical value as evaluated from 331 enteroclysis and follow-through examinations.  Acta Radiol. 1989;  30 621-626
  CrossrefPubMedGoogle Scholar
• 123 Lipson A, Bartram C I, Williams C B. et al . Barium studies and ileoscopy compared in children with suspected Crohn’s disease.  Clin Radiol. 1990;  41 5-8
  CrossrefPubMedGoogle Scholar
• 124 Halligan S, Nicholls S, Beattie R M. et al . The role of small bowel radiology in the diagnosis and management of Crohn’s disease.  Acta Paediatr. 1995;  84 1375-1378
  CrossrefPubMedGoogle Scholar
• 125 Batres L A, Maller E S, Ruchelli E. et al . Terminal ileum intubation in pediatric colonoscopy and diagnostic value of conventional small bowel contrast radiography in pediatric inflammatory bowel disease.  J Pediatr Gastroenterol Nutr. 2002;  35 320-323
  CrossrefPubMedGoogle Scholar
• 126 Gaca A M, Jaffe T A, Delaney S. et al . Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease.  Pediatric Radiology. 2008;  38 285-291
  PubMedGoogle Scholar
• 127 Jamieson D H, Shipman P J, Israel D M, Jacobson K. Comparison of multidetector CT and barium studies of the small bowel: inflammatory bowel disease in children.  AJR American Journal of Roentgenology. 2003;  180 1211-1216
  PubMedGoogle Scholar
• 128 Charron M, di Lorenzo C, Kocoshis S. CT and 99mTc-WBC vs colonoscopy in the evaluation of inflammation and complications of inflammatory bowel diseases.  J Gastroenterol Hepatol. 2002;  37 23-28
  PubMedGoogle Scholar
• 129 Durno C A, Sherman P, Williams T. et al . Magnetic resonance imaging to distinguish the type and severity of pediatric inflammatory bowel diseases.  J Pediatr Gastroenterol Nutr. 2000;  30 170-174
  CrossrefPubMedGoogle Scholar
• 130 Laghi A, Borrelli O, Paolantonio P. et al . Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease.  Gut. 2003;  52 393-397
  CrossrefPubMedGoogle Scholar
• 131 Pilleul F, Godefroy C, Yzebe-Beziat D. et al . Magnetic resonance imaging in Crohn’s disease.  Gastroenterol Clin Biol. 2005;  29 803-808
  CrossrefPubMedGoogle Scholar
• 132 Darbari A, Sena L, Argani P. et al . Gadolinium-enhanced magnetic resonance imaging: A useful radiological tool in diagnosing pediatric IBD.  Inflamm Bowel Dis. 2004;  10 67-72
  CrossrefPubMedGoogle Scholar
• 133 Masselli G, Casciani E, Polettini E, Gualdi G. Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn’s disease.  Eur Radiol. 2008;  18 438-447
  CrossrefPubMedGoogle Scholar
• 134 Davies G R, Benson M J, Gertner D J. et al . Diagnostic and therapeutic push type enteroscopy in clinical use.  Gut. 1995;  37 346-352
  PubMedGoogle Scholar
• 135 Darbari A, Kalloo A N, Cuffari C. Diagnostic yield, safety, and efficacy of push enteroscopy in pediatrics.  Gastrointest Endosc. 2006;  64 224-228
  CrossrefPubMedGoogle Scholar
• 136 Xu C D, Deng C H, Zhong J, Zhang C L. [Application of double-balloon push enteroscopy in diagnosis of small bowel disease in children].  Zhonghua Er Ke Za Zhi. 2006;  44 90-92
  PubMedGoogle Scholar
• 137 Biagi F, Rondonotti E, Campanella J. et al . Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers.  Clin Gastroenterol Hepatol. 2006;  4 998-1003
  CrossrefPubMedGoogle Scholar
• 138 van Tuyl S A, den Ouden H, Stolk M F, Kuipers E J. Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study.  Endoscopy. 2007;  39 1037-1040
  Article in Thieme ConnectPubMedGoogle Scholar
• 139 Dai N, Gubler C, Hengstler P. et al . Improved capsule endoscopy after bowel preparation.  Gastrointest Endosc. 2005;  61 28-31
  CrossrefPubMedGoogle Scholar
• 140 Viazis N, Sgouros S, Papaxoinis K. et al . Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study.  Gastrointest Endosc. 2004;  60 534-538
  CrossrefPubMedGoogle Scholar
• 141 Cheifetz A S, Kornbluth A A, Legnani P. et al . The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease.  Am J Gastroenterol. 2006;  101 2218-2222
  CrossrefPubMedGoogle Scholar
• 142 Cheifetz A S, Lewis B S. Capsule endoscopy retention: is it a complication?.  J Clin Gastroenterol. 2006;  40 688-691
  CrossrefPubMedGoogle Scholar
• 143 Cheon J H, Kim Y S, Lee I S. et al . Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.  Endoscopy. 2007;  39 1046-1052
  Article in Thieme ConnectPubMedGoogle Scholar
• 144 Rondonotti E, Herrerias J M, Pennazio M. et al . Complications, limitations, and failures of capsule endoscopy: a review of 733 cases.  Gastrointest Endosc. 2005;  62 712-716; quiz 752, 754
  CrossrefPubMedGoogle Scholar
• 145 Sturniolo G C, Di Leo V, Vettorato M G. et al . Small bowel exploration by wireless capsule endoscopy: results from 314 procedures.  Am J Med. 2006;  119 341-347
  CrossrefPubMedGoogle Scholar
• 146 Buchman A L, Miller F H, Wallin A. et al . Videocapsule endoscopy versus barium contrast studies for the diagnosis of Crohn’s disease recurrence involving the small intestine.  Am J Gastroenterol. 2004;  99 2171-2177
  CrossrefPubMedGoogle Scholar
• 147 Goldstein J L, Eisen G M, Lewis B. et al . Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo.  Clin Gastroenterol Hepatol. 2005;  3 133-141
  CrossrefPubMedGoogle Scholar
• 148 Leighton J A, Srivathsan K, Carey E J. et al . Safety of wireless capsule endoscopy in patients with implantable cardiac defibrillators.  Am J Gastroenterol. 2005;  100 1728-1731
  CrossrefPubMedGoogle Scholar
• 149 Dubner S, Dubner Y, Gallino S. et al . Electromagnetic interference with implantable cardiac pacemakers by video capsule.  Gastrointest Endosc. 2005;  61 250-254
  CrossrefPubMedGoogle Scholar
• 150 Bandorski D, Irnich W, Bruck M. et al . Capsule endoscopy and cardiac pacemakers: investigation for possible interference.  Endoscopy. 2008;  40 36-39
  Article in Thieme ConnectPubMedGoogle Scholar
• 151 Yang R, Laine L. Mucosal stripping: a complication of push enteroscopy.  Gastrointest Endosc. 1995;  41 156-158
  CrossrefPubMedGoogle Scholar
• 152 Landi B, Cellier C, Fayemendy L. et al . Duodenal perforation occurring during push enteroscopy.  Gastrointest Endosc. 1996;  43 631
  PubMedGoogle Scholar
• 153 Wilmer A, Rutgeerts P. Push enteroscopy. Technique, depth, and yield of insertion.  Gastrointest Endosc Clin N Am. 1996;  6 759-776
  PubMedGoogle Scholar
• 154 Chong J, Tagle M, Barkin J S, Reiner D K. Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathology.  Am J Gastroenterol. 1994;  89 2143-2146
  PubMedGoogle Scholar
• 155 Shimizu S, Tada M, Kawai K. Development of a new insertion technique in push-type enteroscopy.  Am J Gastroenterol. 1987;  82 844-847
  PubMedGoogle Scholar
• 156 Zaman A, Sheppard B, Katon R M. Total peroral intraoperative enteroscopy for obscure GI bleeding using a dedicated push enteroscope: diagnostic yield and patient outcome.  Gastrointest Endosc. 1999;  50 506-510
  CrossrefPubMedGoogle Scholar
• 157 Kopacova M, Rejchrt S, Tacheci I, Bures J. Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy.  Gastrointest Endosc. 2007;  66 1133-1138
  CrossrefPubMedGoogle Scholar
• 158 Honda K, Itaba S, Mizutani T. et al . An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: an association with the development of pancreatitis.  Endoscopy. 2006;  38 1040-1043
  Article in Thieme ConnectPubMedGoogle Scholar
• 159 Jarbandhan S VA, van Weyenberg S JB, van der Veer W M. et al . Double balloon endoscopy associated pancreatitis: a description of six cases.  World J Gastroenterol. 2008;  14 720-724
  CrossrefPubMedGoogle Scholar
• 160 Mensink P BF, Haringsma J, Kucharzik T. et al . Complications of double balloon enteroscopy: a multicenter survey.  Endoscopy. 2007;  39 613-615
  Article in Thieme ConnectPubMedGoogle Scholar
• 161 Moschler O, May A D, Muller M K, Ell C. [Complications in double-balloon-enteroscopy: results of the German DBE register].  Z Gastroenterol. 2008;  46 266-270
  Article in Thieme ConnectPubMedGoogle Scholar
• 162 Kastin D A, Buchman A L, Barrett T. et al . Strictures from Crohn’s disease diagnosed by video capsule endoscopy.  J Clin Gastroenterol. 2004;  38 346-349
  CrossrefPubMedGoogle Scholar
• 163 Lewis B. Capsule endoscopy – transit abnormalities.  Gastrointest Endosc Clin N Am. 2006;  16 221-228, vii
  CrossrefPubMedGoogle Scholar
• 164 Sears D M, Avots-Avotins A, Culp K, Gavin M W. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin.  Gastrointest Endosc. 2004;  60 822-827
  CrossrefPubMedGoogle Scholar
• 165 Baichi M M, Arifuddin R M, Mantry P S. What we have learned from 5 cases of permanent capsule retention.  Gastrointest Endosc. 2006;  64 283-287
  CrossrefPubMedGoogle Scholar
• 166 Fry L C, De Petris G, Swain J M, Fleischer D E. Impaction and fracture of a video capsule in the small bowel requiring laparotomy for removal of the capsule fragments.  Endoscopy. 2005;  37 674-676
  Article in Thieme ConnectPubMedGoogle Scholar
• 167 Repici A, Barbon V, De AC . et al . Acute small-bowel perforation secondary to capsule endoscopy.  Gastrointest Endosc. 2008;  67 180-183
  CrossrefPubMedGoogle Scholar
• 168 Lee B-I, Choi H, Choi K-Y. et al . Retrieval of a retained capsule endoscope by double-balloon enteroscopy.  Gastrointest Endosc. 2005;  62 463-465
  CrossrefPubMedGoogle Scholar
• 169 Tanaka S, Mitsui K, Shirakawa K. et al . Successful retrieval of video capsule endoscopy retained at ileal stenosis of Crohn’s disease using double-balloon endoscopy.  J Gastroenterol Hepatol. 2006;  21 922-923
  CrossrefPubMedGoogle Scholar
• 170 Banerjee R, Bhargav P, Reddy P. et al . Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical trial.  J Gastroenterol Hepatol. 2007;  22 2060-2063
  CrossrefPubMedGoogle Scholar
• 171 Spada C, Shah S K, Riccioni M E. et al . Video capsule endoscopy in patients with known or suspected small bowel stricture previously tested with the dissolving patency capsule.  J Clin Gastroenterol. 2007;  41 576-582
  CrossrefPubMedGoogle Scholar
• 172 Signorelli C, Rondonotti E, Villa F. et al . Use of the Given Patency System for the screening of patients at high risk for capsule retention.  Dig Liver Dis. 2006;  38 326-330
  CrossrefPubMedGoogle Scholar
• 173 Sachdev M S, Leighton J A, Fleischer D E. et al . A prospective study of the utility of abdominal radiographs after capsule endoscopy for the diagnosis of capsule retention.  Gastrointest Endosc. 2007;  66 894-900
  CrossrefPubMedGoogle Scholar
• 174 De Bona M, Bellumat A, Cian E. et al . Capsule endoscopy findings in patients with suspected Crohn’s disease and biochemical markers of inflammation.  Dig Liver Dis. 2006;  38 331-335
  CrossrefPubMedGoogle Scholar
• 175 Valle J, Alcantara M, Perez-Grueso M J. et al . Clinical features of patients with negative results from traditional diagnostic work-up and Crohn’s disease findings from capsule endoscopy.  J Clin Gastroenterol. 2006;  40 692-696
  CrossrefPubMedGoogle Scholar
• 176 Fidder H H, Nadler M, Lahat A. et al . The utility of capsule endoscopy in the diagnosis of Crohn’s disease based on patient’s symptoms.  J Clin Gastroenterol. 2007;  41 384-387
  CrossrefPubMedGoogle Scholar
• 177 Shim K-N, Kim Y-S, Kim K-J. et al . Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study.  Scand J Gastroenterol. 2006;  41 983-988
  CrossrefPubMedGoogle Scholar
• 178 Bardan E, Nadler M, Chowers Y. et al . Capsule endoscopy for the evaluation of patients with chronic abdominal pain.  Endoscopy. 2003;  35 688-689
  Article in Thieme ConnectPubMedGoogle Scholar
• 179 May A, Manner H, Schneider M. et al . Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study).  Endoscopy. 2007;  39 606-612
  Article in Thieme ConnectPubMedGoogle Scholar
• 180 Adler S N, Bjarnason I, Metzger Y C. New balloon-guided technique for deep small-intestine endoscopy using standard endoscopes.  Endoscopy. 2008;  40 502-505
  Article in Thieme ConnectPubMedGoogle Scholar
• 181 Pennazio M, Santucci R, Rondonotti E. et al . Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases.  Gastroenterology. 2004;  126 643-653
  CrossrefPubMedGoogle Scholar
• 182 Li F, Gurudu S R, De Petris G. et al . Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures.  Gastrointest Endosc. 2008;  68 174-180
  CrossrefPubMedGoogle Scholar

1 Contributed equally

A. Van GossumMD 

Department of Gastroenterology, Hepatopancreatology and GI Oncology
Erasme University Hospital, Université Libre de Bruxelles

Route de Lennik 808
1070 Brussels
Belgium

Fax: +32-2-5554697

Email: Andre.VanGossum@erasme.ulb.ac.be