Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Technology Insight: current status of video capsule endoscopy

Nature Clinical Practice Gastroenterology & Hepatology volume 3, pages 158–164 (2006)Cite this article

Abstract

Video capsule endoscopy (VCE) is the most recent major practical and conceptual development in the field of endoscopy. The video capsule endoscope—a small, pill-sized, passive imaging device—has been demonstrated to be the pre-eminent imaging device for disorders of the small intestine. The initial use for VCE was to detect the origin of obscure gastrointestinal bleeding. Several other indications have now been justified, or are in the process of evaluation. More than 200,000 of these disposable devices have been used worldwide, with an extraordinarily good safety record: indeed, the device has been approved for use in children as young as 10 years of age. In addition, a double-ended capsule has now been approved for the evaluation of mucosal disease in the esophagus. The now-widespread deployment of the device into gastrointestinal practice in the US and many other countries suggests that VCE has achieved mainstream utility. The development of similar competitor devices, and devices whose movement can be controlled, is in progress.

Key Points

  • The video capsule endoscope is the first digital imaging device for the small intestine that provides high-resolution images of most of the mucosa

  • The diagnostic ability of the video capsule endoscope surpasses that of all other small-bowel diagnostic tools combined

  • The video capsule endoscope is a safe and effective device: occasionally retention occurs, but it does not cause obstruction

  • Video capsule endoscopy is in its infancy: new indications, devices and applications can be anticipated in the near future

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Video capsule endoscopy images.

Similar content being viewed by others

References

  1. Iddan GJ and Swain CP (2004) History and development of capsule endoscopy. Gastrointest Endosc Clin N Am 14: 1–9

    Article  Google Scholar 

  2. Cave DR (2004) Reading wireless video capsule endoscopy. Gastrointest Endosc Clin N Am 14: 17–24

    Article  Google Scholar 

  3. D'Halluin PN et al. (2005) Does the “Suspected Blood Indicator” improve the detection of bleeding lesions by capsule endoscopy? Gastrointest Endosc 61: 243–249

    Article  Google Scholar 

  4. Liangpunsakul S et al. (2003) Performance of Given suspected blood indicator. Am J Gastroenterol 98: 2676–2678

    Article  Google Scholar 

  5. Lewis BS and Swain P (2002) Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study. Gastrointest Endosc 56: 349–353

    Article  Google Scholar 

  6. Friedman S (2004) Comparison of capsule endoscopy to other modalities in small bowel. Gastrointest Endosc Clin N Am 14: 51–60

    Article  Google Scholar 

  7. Seidman EG et al. (2004) Potential applications of wireless capsule endoscopy in the pediatric age group. Gastrointest Endosc Clin N Am 14: 207–217

    Article  Google Scholar 

  8. Leighton JA et al. (2004) Safety of capsule endoscopy in patients with pacemakers. Gastrointest Endosc 59: 567–569

    Article  Google Scholar 

  9. Leighton JA et al. (2005) Safety of wireless capsule endoscopy in patients with implantable cardiac defibrillators. Am J Gastroenterol 100: 1728–1731

    Article  Google Scholar 

  10. De Franchis R et al. (2005) ICCE consensus for bowel preparation and prokinetics. Endoscopy 37: 1040–1045

    Article  CAS  Google Scholar 

  11. Selby W (2005) Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc 61: 80–85

    Article  Google Scholar 

  12. Albert J et al. (2004) Simethicone for small bowel preparation for capsule endoscopy: a systematic, single-blinded, controlled study. Gastrointest Endosc 59: 487–491

    Article  Google Scholar 

  13. Sachdev R et al. (2005) Reduction of gastric transit time of video capsule endoscopy by right lateral positioning [abstract]. Gastrointest Endosc 59: AB176

    Article  Google Scholar 

  14. Pennazio M et al. (2005) ICCE consensus for obscure gastrointestinal bleeding. Endoscopy 37: 1046–1050

    Article  CAS  Google Scholar 

  15. Pennazio M et al. (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126: 643–653

    Article  Google Scholar 

  16. Adler DG et al. (2004) A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 59: 492–498

    Article  Google Scholar 

  17. Mata A et al. (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 20: 189–194

    Article  CAS  Google Scholar 

  18. Sachdev R et al. (2004) Capsule endoscopy in the emergency room for acute non-hematemesis gastrointestinal bleeding [abstract]. Am J Gastroenterol 99: S295

    Google Scholar 

  19. Chong AK et al. (2005) Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn's disease. Gastrointest Endosc 61: 255–261

    Article  Google Scholar 

  20. Eliakim R et al. (2003) Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn's disease. Eur J Gastroenterol Hepatol 15: 363–367

    Article  Google Scholar 

  21. Buchman AL et al. (2004) Video capsule endoscopy versus barium contrast studies for the diagnosis of Crohn's disease recurrence involving the small intestine. Am J Gastroenterol 99: 2171–2177

    Article  Google Scholar 

  22. Mitty R and Cave DR (2002) Focal villous denudation: a precursor to aphthoid ulcers in Crohn's disease as detected by video capsule endoscopy [abstract #1-5-0002]. Gastroenterology 122: A217

    Google Scholar 

  23. Lo SK (2004) Capsule endoscopy in the diagnosis and management of inflammatory bowel disease. Gastrointest Endosc Clin N Am 14: 179–193

    Article  Google Scholar 

  24. Mow WS et al. (2004) Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hepatol 2: 31–40

    Article  Google Scholar 

  25. Kornbluth A et al. (2005) ICCE consensus for inflammatory bowel disease. Endoscopy 37: 1051–1054

    Article  CAS  Google Scholar 

  26. Dube C et al. (2005) The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review. Gastroenterology 128 (Suppl 1): S57–S67

    Article  Google Scholar 

  27. Rostom A et al. (2005) The diagnostic accuracy of serologic tests for celiac disease: a systematic review. Gastroenterology 128 (Suppl 1): S38–S46

    Article  Google Scholar 

  28. De Franchis R et al. (2005) Video capsule endoscopy for the diagnosis of celiac disease; preliminary results froma multicenter study. Gastroenterology 128 (Suppl 2): 548

    Google Scholar 

  29. Apostolopoulos P et al. (2004) M2A wireless capsule endoscopy for diagnosing ulcerative jejunoileitis complicating celiac disease. Endoscopy 36: 247

    Article  CAS  Google Scholar 

  30. Culliford A et al. (2005) The value of wireless capsule endoscopy in patients with complicated celiac disease. Gastrointest Endosc 62: 55–61

    Article  Google Scholar 

  31. Petroniene R et al. (2004) Given capsule endoscopy in celiac disease. Gastrointest Endosc Clin N Am 14: 115–127

    Article  Google Scholar 

  32. Lee SK and Green PH (2005) Endoscopy in celiac disease. Curr Opin Gastroenterol 21: 589–594

    Article  Google Scholar 

  33. Cellier C et al. (2005) ICCE consensus for celiac disease. Endoscopy 37: 1055–1059

    Article  CAS  Google Scholar 

  34. Carey E et al. (2004) The value of capsule endoscopy for evaluation of abdominal pain and or diarrhea [abstract]. Gastroenterology 126: A460

    Article  Google Scholar 

  35. Keuchel M and Hagenmuller F (2004) Video capsule endoscopy in the work-up of abdominal pain. Gastrointest Endosc Clin N Am 14: 195–205

    Article  Google Scholar 

  36. Bardan E et al. (2003) Capsule endoscopy for the evaluation of patients with chronic abdominal pain [abstract]. Endoscopy 35: 688–699

    Article  CAS  Google Scholar 

  37. De Franchis R et al. (2004) Small bowel malignancy. Gastrointest Endosc Clin N Am 14: 139–148

    Article  Google Scholar 

  38. Mata A et al. (2005) A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes. Gastrointest Endosc 61: 721–725

    Article  Google Scholar 

  39. Schulmann K and Schmiegel W (2004) Capsule endoscopy for small bowel surveillance in hereditary intestinal polyposis and non-polyposis syndromes. Gastrointest Endosc Clin N Am 14: 149–158

    Article  Google Scholar 

  40. Schulmann K et al. (2005) Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes. Am J Gastroenterol 100: 27–37

    Article  Google Scholar 

  41. De Franchis R et al. (2003) Capsule enteroscopy in small bowel transplantation. Dig Liver Dis 35: 728–731

    Article  CAS  Google Scholar 

  42. Yakoub-Agha I et al. (2004) Impact of small bowel exploration using video-capsule endoscopy in the management of acute gastrointestinal graft-versus-host disease. Transplantation 78: 1697–1701

    Article  Google Scholar 

  43. Goldstein JL et al. (2005) Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo [abstract]. Clin Gastroenterol Hepatol 3: 133–141

    Article  Google Scholar 

  44. Graham DY et al. (2005) Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol 3: 55–59

    Article  Google Scholar 

  45. Maiden L et al. (2005) A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy. Gastroenterology 128: 1172–1178

    Article  Google Scholar 

  46. Fix OK et al. (2005) Obscure gastrointestinal hemorrhage from mesenteric varices diagnosed by video capsule endoscopy. Dig Dis Sci (in press)

  47. Eliakim R et al. (2004) A novel diagnostic tool for detecting oesophageal pathology: the PillCam oesophageal video capsule. Aliment Pharmacol Ther 20: 1083–1089

    Article  CAS  Google Scholar 

  48. Eliakim R et al. (2005) A prospective study of the diagnostic accuracy of PillCam ESO esophageal capsule endoscopy versus conventional upper endoscopy in patients with chronic gastroesophageal reflux diseases. J Clin Gastroenterol 39: 572–578

    Article  Google Scholar 

  49. Sharma VK et al. (2005) ICCE consensus for esophageal capsule endoscopy. Endoscopy 37: 1060–1064

    Article  CAS  Google Scholar 

  50. Ramirez FC et al. (2005) Feasibility and safety of string wireless capsule endoscopy in the diagnosis of esophageal varices. Am J Gastroenterol 100: 1065–1071

    Article  Google Scholar 

  51. De Franchis R et al. (2005) Esophageal capsule endoscopy (PillCam Eso) is comparable to traditional endocopy for screening/sureillance for esophageal varices. Hepatology 42 (Suppl S1): 804A

    Google Scholar 

  52. Cave D et al. (2005) ICCE Consensus for Capsule Retention. Endoscopy 10: 1065–1070

    Article  Google Scholar 

  53. Spada C et al. (2005) A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule. Endoscopy 37: 793–800

    Article  CAS  Google Scholar 

  54. Yamamoto H and Kita H (2005) Double-balloon endoscopy. Curr Opin Gastroenterol 21: 573–577

    Article  Google Scholar 

  55. Matsumoto T et al. (2005) Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis. Endoscopy 37: 827–832

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Professor of Medicine and Director of Clinical Gastroenterology Research at the University of Massachusetts Medical Center, Worcester, MA, USA

    David R Cave

Authors
  1. David R Cave
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David R Cave.

Ethics declarations

Competing interests

David R Cave has received research support and been a speaker for Given Imaging.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cave, D. Technology Insight: current status of video capsule endoscopy. Nat Rev Gastroenterol Hepatol 3, 158–164 (2006). https://doi.org/10.1038/ncpgasthep0416

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpgasthep0416

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing