Department of Gastroenterology and Alimentary Tract Surgery, Medical School, University of Tampere, Tampere, Finland.
J Dig Dis. 2012 Feb;13(2):94-9. doi: 10.1111/j.1751-2980.2011.00561.x.
A complete examination of the small intestine is possible by video capsule endoscopy (VCE). The aim of this study was to evaluate current indications for performing VCE in celiac disease.
In all 84 celiac disease patients on a gluten-free diet who had undergone VCE were enrolled at five centers in Europe. The indications, findings and clinical impact of VCE were recorded by a structured questionnaire. VCE was also carried out in 34 consecutive patients with untreated celiac disease (controls) in another center.
Out of the 84 patients, 34 had overt symptoms and small intestinal histology compatible with refractory celiac disease. VCE was normal in 9 patients, and 7 had only proximal and one distal atrophy, 14 had intestinal ulcer and 2 an intestinal stricture. VCE was used in the adjustment of immunosuppressive treatment in 9 patients. In the remaining 50 patients, a VCE was performed because of less severe symptoms, 31 of which had an earlier histological recovery. The VCE showed proximal small bowel atrophy in 21 and distal atrophy in 3 patients, and 3 ulcers were seen. In this group the patients received mainly advice with a view to achieving better dietary compliance. Of the 34 newly detected celiac patients, 4 were normal, 27 proximal and 3 had distal small intestinal atrophy in the VCE.
VCE has a definite impact on the management of refractory sprue. In the remaining patients with established celiac disease, the procedure plays a more limited role.
视频胶囊内镜（VCE）可对小肠进行全面检查。本研究旨在评估 VCE 在乳糜泻中的当前适应证。
在欧洲五个中心，共纳入 84 例接受无麸质饮食的乳糜泻患者，这些患者均接受了 VCE 检查。通过结构化问卷记录 VCE 的适应证、发现和临床影响。在另一个中心，还对 34 例未经治疗的乳糜泻患者（对照组）连续进行了 VCE 检查。
在 84 例患者中，34 例有显性症状和符合难治性乳糜泻的小肠组织学表现。9 例 VCE 正常，7 例仅近端和 1 例远端萎缩，14 例有肠溃疡，2 例有肠狭窄。9 例患者在调整免疫抑制治疗时使用了 VCE。在其余 50 例症状较轻的患者中，进行了 VCE 检查，其中 31 例的组织学恢复较早。VCE 显示近端小肠萎缩 21 例，远端小肠萎缩 3 例，发现 3 例溃疡。在这一组患者中，主要给予了关于改善饮食依从性的建议。在新发现的 34 例乳糜泻患者中，4 例正常，27 例有近端小肠萎缩，3 例有远端小肠萎缩。
VCE 对难治性口炎性腹泻的治疗有明确影响。在已确诊的乳糜泻患者中，该检查的作用较为有限。
