| Theme |
An algorithm for finding and treatment of small intestinal disease -- DBE and CE |
| Title |
Advancements in diagnosis and treatment for small bowel diseases with double balloon endoscopy and capsule endoscopy in Japan |
| Author |
Choitsu Sakamoto |
Division of Gastroenterology, Department of Medicine, Nippon Medical School |
| Author |
Shu Tanaka |
Division of Gastroenterology, Department of Medicine, Nippon Medical School |
| Author |
Keigo Mitsui |
Division of Gastroenterology, Department of Medicine, Nippon Medical School |
| Author |
Atsushi Tatsuguchi |
Division of Gastroenterology, Department of Medicine, Nippon Medical School |
| Author |
Shunji Fujimori |
Division of Gastroenterology, Department of Medicine, Nippon Medical School |
| [ Summary ] |
It has been four years since two modalities, capsule endoscopy (CE) and double balloon endoscopy (DBE), were first introduced for diagnosis and treatment of small bowel diseases. International consensus meetings on CE and DBE held this year suggest that early application of either modality is important for diagnostic yield in cases of obscure gastrointestinal bleeding (OGIB). In overt ongoing OGIB cases, early DBE application was especially recommended as a therapeutic modality if the DBE technique is available and applicable. However, further studies are clearly needed to clarify which modality would result in better outcomes when either was used first for OGIB patients. Small bowel erosions and ulcerations are also good indications for CE and DBE examinations. While CE is a good modality for screening subjects complaining of symptoms that may indicate small bowel diseases, a definite diagnosis may not be obtained by CE application alone because of the inability to obtain a tissue biopsy. On the other hand, DBE seems to be a good tool to obtain not only clear endoscopic views but also tissue biopsies and thus may diagnosis. Therefore, these two modalities seem to complement each other regarding how to approach to the suspected small bowel disease patients. Specificity and sensitivity data of specific DBE findings would be necessary as a future issue when the findings are likely to indicate of certain small bowel diseases, such as tuberculosis or Crohn's disease. |