The role of video capsule endoscopy in the diagnosis of gastrointestinal diseases: experience of the Department of Diagnostic and Operative Endoscopy

Abstract

Introduction. Video capsule endoscopy (VSE) is a gold standard diagnostic method for small bowel diseases and is widely used in clinical practice. The presented analysis of the VCE results demonstrates the possibilities of this diagnostic tool and is the largest one of the analysis that were recently published in Russia. Aim. To demonstrate the possibilities of video capsule endoscopy in the diagnosis of small bowel diseases. Materials and methods. A total of 300 video capsule endoscopies were performed in patients with suspected and already established small bowel diseases between 2014 and 2022. All patients who underwent a video capsule endoscopy in the settings of the National Medical Research Center of Coloproctology named after A.N. Ryzhikh were over 18 years old. The study cohort included 158 men and 142 women. The average age of patients at the time of the video capsule endoscopy was 42 ± 15.4 years. The patients were recommended a standard preparation regimen: 3 days before the study, a protein diet was prescribed, and the day before, a two-stage administration of a PEGbased drug (“split dose”). To reduce gas production and decrease the amount of foamy intestinal contents, which worsens the quality of the endoscopic image, oral administration of an antifoam agent simethicone was prescribed: 80 mg on the eve of the endoscopy and 80 mg on the day of the endoscopy. Results. The video capsule endoscopy demonstrated high information value in the diagnosis of inflammatory bowel diseases: its sensitivity was 86%, and specificity – 90%. Similar results were obtained during video capsule endoscopy used to diagnose the source of possible bleeding: sensitivity and specificity were 87 and 68%, respectively. Conclusion. Video capsule endoscopy is an effective, safe and well-tolerated tool for diagnosing small bowel diseases. The video capsule endoscopy findings contribute to establishing a correct diagnosis and selecting treatment strategies.