The diagnostic value of video capsule endoscopy.

Abstract

BACKGROUND AND AIMS: Video capsule endoscopy (VCE) offers the best means of studying small bowel, but is expensive. We investigated how physicians appraise the value of VCE. METHODS: A questionnaire was sent to remitting physicians comprising questions on the value of VCE in altogether 189 adults. The follow-up time was at least one year. The patient history was also scrutinized in case records. RESULTS: The most common indications for VCE were anaemia (n=100) or gastrointestinal bleeding (n=21) (60%), suspicion of Crohn's disease (21%), abdominal pain (9%) and coeliac disease (6%). The diagnostic value of VCE was rated best in patients suffering from anaemia or bleeding, being decisive or beneficial in 33% (OR 2.3, CI=1.1-4.8 compared to all series) and helpful in exclusion in an additional 36%. In Crohn's disease, VCE was helpful in the exclusion of intestinal lesions in 50% of cases; in coeliac disease the corresponding percentage was 42%. When abdominal pain was the only indication for VCE, the examination was beneficial in one patient only. CONCLUSIONS: The diagnostic value of VCE was evident in patients with anaemia or gastrointestinal bleeding. The procedure was deemed to be helpful in exclusion also in Crohn's disease and in coeliac disease. Abdominal pain was a rare indication, and the diagnostic yield limited.