Panenteric Capsule Endoscopy in Young Patients with Suspected Irritable Bowel Syndrome: A Self-Controlled Feasibility Study

Robert Benamouzig; Walaa El Arja; Bakthiar Bejou; Gheorghe Airinei; Nahla Cucherousset; Abdelhakim Tazairt; Mourad Benallaoua; Fabien Wuestenberghs; Jean-Marc Sabaté

doi:10.2147/CEG.S513612

Panenteric Capsule Endoscopy in Young Patients with Suspected Irritable Bowel Syndrome: A Self-Controlled Feasibility Study

Clin Exp Gastroenterol. 2025 Sep 6:18:205-213. doi: 10.2147/CEG.S513612. eCollection 2025.

Authors

Robert Benamouzig¹, Walaa El Arja¹, Bakthiar Bejou¹, Gheorghe Airinei¹, Nahla Cucherousset², Abdelhakim Tazairt¹, Mourad Benallaoua¹, Fabien Wuestenberghs¹, Jean-Marc Sabaté¹

Affiliations

¹ Gastroenterology & Digestive Oncology Department, Avicenne University Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France.
² Pathology Department, Avicenne University Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France.

Abstract

Objective: Although the diagnosis of irritable bowel syndrome (IBS) is based on clinical criteria, a colonoscopy is often performed to rule out alternative digestive disorders. The panenteric PillCam™ Crohn's capsule, which allows non-invasive examination of both the small bowel and the colon, may be an alternative investigation. We aimed to evaluate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS as an alternative to the classical approach based on colonoscopy.

Design: Of 42 consecutive adults aged 18-50 years with symptoms consistent with IBS for more than 6 months, 33 were enrolled, and 27 received both routine biological tests, fecal calprotectin, panenteric capsule, and gastrointestinal endoscopies.

Results: All 21 lesions identified by the capsule in 15 patients were unrelated to digestive symptoms, as were the 11 lesions identified by colonoscopy in 7 patients, and all were of little or no clinical interest. In addition, one gastric ulcer and one gastric MALT lymphoma diagnosed only by systematic gastric biopsy were characterized by upper endoscopy. The capsule was preferred by all patients to the classical endoscopic procedures.

Conclusion: The diagnosis of IBS was not called into question in any of the patients explored. These preliminary results demonstrate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS.

Keywords: PillCam™ Crohn’s capsule; capsule endoscopy; colonoscopy; irritable bowel syndrome; panenteric capsule.

Plain language summary

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and altered bowel transit without structural lesions explaining the symptoms. A diagnosis of IBS is clinical, but a colonoscopy can exclude other bowel disorders. Panenteric capsule endoscopy, an alternative to colonoscopy, noninvasively examines the small bowel and colon. We aimed to evaluate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude other gastrointestinal diseases in young adult patients with chronic abdominal symptoms suggestive of IBS as an alternative to the classical approach based on colonoscopy. Our study shows that the use of pancapsule in young adults with IBS symptoms is feasible, with all patients preferring the pancapsule over colonoscopy, indicating higher acceptability. Furthermore, lesions found by capsule and colonoscopy were unrelated to symptoms, and the IBS diagnosis remained unchanged, suggesting that the pancapsule was sufficient. In conclusion, pancapsule endoscopy could be a feasible alternative to colonoscopy for young adults with suspected IBS.