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World J Gastrointest Endosc. Oct 16, 2012; 4(10): 448-452
Published online Oct 16, 2012. doi: 10.4253/wjge.v4.i10.448
What we have learned and what to expect from capsule endoscopy
Samuel N Adler, Ingvar Bjarnason
Samuel N Adler, Division of Gastroenterology, Bikur Holim Hospital, Jerusalem 95142, Israel
Ingvar Bjarnason, Department of Gastroenterology, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom
Author contributions: Authors contributed equally for the development of the manuscript.
Correspondence to: Samuel N Adler, MD, Division of Gastroenterology, Bikur Holim Hospital, 5 Strauss Street, POB 492, Jerusalem 95142, Israel. nasnadler@gmail.com
Telephone: +972-2-6464206 Fax: +972-2-6464378
Received: April 29, 2012
Revised: August 26, 2012
Accepted: October 10, 2012
Published online: October 16, 2012
Abstract

Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn’s disease of the small bowel, occult gastrointestinal bleeding, non steroidal anti inflammatory drug induced small bowel disease, carcinoid tumors of the small bowel, gastro intestinal stromal tumors of the small bowel and other disease affecting the small bowel. Capsule endoscopy has been compared to traditional small bowel series, computerized tomography studies and push enteroscopy. The diagnostic yield of capsule endoscopy has consistently been superior in the diagnosis of small bowel disease compared to the competing methods (small bowel series, computerized tomography, push enteroscopy) of diagnosis. For this reason capsule endoscopy has enjoyed a meteoric success. Image quality has been improved with increased number of pixels, automatic light exposure adaptation and wider angle of view. Further applications of capsule endoscopy of other areas of the digestive tract are being explored. The increased transmission rate of images per second has made capsule endoscopy of the esophagus a realistic possibility. Technological advances that include a double imager capsule with a nearly panoramic view of the colon and a variable frame rate adjusted to the movement of the capsule in the colon have made capsule endoscopy of the colon feasible. The diagnostic rate for the identification of patients with polyps equal to or larger than 6 mm is high. Future advances in technology and biotechnology will lead to further progress. Capsule endoscopy is following the successful modern trend in medicine that replaces invasive tests with less invasive methodology.

Keywords: Capsule endoscopy; Cancer screening; Colon cancer; Artificial intelligence; Technology