Lahat Adi, Veisman Ido
Chaim Sheba Medical Center, Department of Gastroenterology, Sackler Medical School, Tel Aviv University, Tel Hashomer 52620, Israel.
Sackler Medical School, Tel Aviv University, Tel Aviv 67011, Israel.
Diagnostics (Basel). 2021 Sep 22;11(10):1737. doi: 10.3390/diagnostics11101737.
Crohn's disease (CD) is a chronic inflammatory disorder that may involve the gastrointestinal tract from the mouth to the anus. Habitual disease monitoring is highly important during disease management, aiming to identify and treat disease exacerbations, in order to avoid immediate and future complications. Currently, ilio-clonoscopy is the gold standard for mucosal assessment. However, the procedure is invasive, involves sedation and allows for visualization of the colon and only a small part of the terminal ileum, while most of the small bowel is not visualized. Since CD may involve the whole length of the small bowel, the disease extent might be underestimated. Capsule endoscopy (CE) provides a technology that can screen the entire bowel in a non-invasive procedure, with minimal side effects. In recent years, this technique has gained in popularity for CD evaluation and monitoring. When CE was first introduced, two decades ago, the fear of possible capsule retention in the narrowed inflamed bowel lumen limited its use in CD patients, and a known CD located at the small bowel was even regarded as a relative contraindication for capsule examination. However, at present, as experience using CE in CD patients has accumulated, this procedure has become one of the accepted tools for disease diagnosis and monitoring. In our current review, we summarize the historic change in the indications and contraindications for the usage of capsule endoscopy for the evaluation of CD, and discuss international recommendations regarding CE's role in CD diagnosis and monitoring.
克罗恩病（CD）是一种慢性炎症性疾病，可累及从口腔至肛门的胃肠道。在疾病管理过程中，进行常规疾病监测非常重要，目的是识别并治疗疾病发作，以避免近期及远期并发症。目前，回结肠镜检查是黏膜评估的金标准。然而，该检查具有侵入性，需要镇静，且只能观察到结肠及末端回肠的一小部分，而大部分小肠无法观察到。由于CD可能累及小肠全长，疾病范围可能被低估。胶囊内镜检查（CE）提供了一种能够以非侵入性方式筛查整个肠道的技术，副作用极小。近年来，这项技术在CD评估和监测方面越来越受欢迎。二十年前，当CE首次被引入时，担心胶囊可能滞留在狭窄的炎症肠腔内限制了其在CD患者中的应用，小肠部位已知的CD甚至被视为胶囊检查的相对禁忌证。然而，目前随着在CD患者中使用CE的经验不断积累，该检查已成为疾病诊断和监测的公认工具之一。在我们当前的综述中，我们总结了胶囊内镜用于评估CD的适应证和禁忌证的历史变化，并讨论了关于CE在CD诊断和监测中作用的国际建议。
