Capsule Endoscopy (cont.)
What are the limitations of capsule endoscopy?
While the capsule provides the best means of viewing the inside of the
small intestine, there are many inherent limitations and problems with its use,
the most important of which is that the capsule does not allow for therapy. Other problems
include:
- Abnormalities in some areas of the intestine are missed because of rapid
transit of the capsule and blurred, uninterpretable photographs.
- At times, transit is so slow that the capsule examines only part of the
small intestine before the battery fails.
- If abnormalities are discovered that require surgical resection or
further investigation, it may be difficult to determine where in the small
intestine the abnormality is and thereby help direct therapy.
- If there are narrow areas due to scarring (strictures) or tumors in the
small intestine, the capsule can get stuck in the narrow area and cause an
obstruction of the intestine that requires surgical removal of the capsule.
(For this reason, in patients who are suspected of having a stricture, a
self-dissolving, dummy capsule is swallowed first. If the dummy capsule
sticks, it can be seen on an x-ray of the abdomen and the location of the
stricture determined. Because it dissolves with time, however, the
obstruction will resolve without surgery, and the real capsule will not be
swallowed.)
- Finally, reviewing the tens of thousands of photographs is very time
consuming for the conscientious physician.
What type of diseases can be diagnosed with capsule endoscopy?
Capsule endoscopy continues to improve technically. It has revolutionized
diagnosis by providing a sensitive (able to identify subtle abnormalities) and
simple (non-invasive) means of examining the inside of the small intestine. Some
common examples of small intestine diseases diagnosed by capsule endoscopy
include:
- Angiodysplasias (collections of small blood vessels located just beneath
the inner intestinal lining that can bleed intermittently and cause anemia)
- Small intestinal tumors such as
lymphoma,
carcinoid tumor, and
small
intestinal cancer
- Crohn's disease of the small intestine
Last Editorial Review: 2/22/2008
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