Technique has limitations

doi:10.1136/bmj.b4282

Published 21 October 2009, doi:10.1136/bmj.b4282
Cite this as: BMJ 2009;339:b4282

Letters

Capsule endoscopy

Technique has limitations

The first 150 words of the full text of this article appear below.

Capsule endoscopy has become an essential tool in investigatingsmall bowel disease.¹ However, a recent paper describes itslimitations compared with optical colonoscopy in detecting bothpolyps and cancers.²

Whereas capsule colonoscopy seems less invasive, it still requiresbowel preparation, which many patients find as unpleasant asundergoing optical colonoscopy. Furthermore, in their studyof 328 cases Van Gossum et al found that its sensitivity andspecificity in detecting colonic polyps greater than 6 mm wasonly 64% and 84% respectively compared with optical colonoscopy.²Similarly, of 19 cancers diagnosed at optical colonoscopy, only14 were detected by capsule endoscopy. Currently optical colonoscopycan be performed in a suboptimally cleansed colon, with thepossibility of clearing colonic debris during the procedure,and insufflating air into collapsed intestines. This is notthe case for capsule colonoscopy.