Capsule Endoscopy in Inflammatory Bowel Disease: Current Status and Issues in Clinical Practice

ABSTRACT Inflammatory bowel diseases include Crohn's disease (CD) and ulcerative colitis (UC), both of which require endoscopic evaluation of mucosal surfaces. Capsule endoscopy has been used in clinical practice since 2000 as a minimally invasive means of mucosal evaluation. In Japan, there is an innovative algorithm that incorporates capsule endoscopy into the diagnostic algorithm for CD. However, capsule retention is a potential complication, and intestinal patency must be evaluated using a patency capsule or other means before capsule ingestion. In addition, the pathophysiology of CD is a combination of inflammation and stenosis, so the interpretation of score values remains an issue to be addressed. Colon capsule endoscopy for UC is useful in understanding the localization and severity of colorectal inflammation. However, capsule endoscopy is not appropriate for cancer surveillance in patients with UC, and further improvements in bowel preparation are needed. Despite these issues, capsule endoscopy, which allows noninvasive observation of mucosal surfaces, is attractive, and further development is expected.