Role of capsule endoscopy in alarm features and non-responsive celiac disease: A European multicenter study

Dig Endosc. 2018 Jul;30(4):461-466. doi: 10.1111/den.13002. Epub 2018 Jan 22.


Background and aim: The role of capsule endoscopy (CE) in established celiac disease (CD) remains unclear. Our objective was to analyze the usefulness of CE in the suspicion of complicated CD.

Methods: This was a retrospective multicenter study. One hundred and eighty-nine celiac patients (mean age: 46.6 ± 16.6, 30.2% males) who underwent CE for alarm symptoms (n = 86, 45.5%) or non-responsive CD (n = 103, 54.5%) were included. Diagnostic yield (DY), therapeutic impact and safety were analyzed.

Results: Capsule endoscopy was completed in 95.2% of patients (small bowel transit time: 270.5 ± 100.2 min). Global DY was 67.2%, detecting atrophic mucosa (n = 92, 48.7%), ulcerative jejunoileitis (n = 21, 11.1%), intestinal lymphoma (n = 7, 3.7%) and other enteropathies (n = 7, 3.7%, six Crohn's disease cases and one neuroendocrine tumor). The DY of CE was significantly higher in patients presenting with non-responsive disease compared to patients with alarm symptoms (73.8% vs 59.3%, P = 0.035). The new findings of the CE modified management in 59.3% of the cases. There were no major complications.

Conclusion: Capsule endoscopy may be a moderately helpful and safe diagnostic tool in the suspicion of complicated CD, modifying the clinical course of these patients.

Keywords: capsule endoscopy; celiac disease; gluten; lymphoma; non-responsive celiac disease.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Capsule Endoscopy / methods*
  • Celiac Disease / diagnosis*
  • Celiac Disease / diet therapy
  • Cohort Studies
  • Diet, Gluten-Free*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Mucosa / pathology*
  • Intestine, Small / pathology
  • Intestine, Small / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Young Adult