Clinical Guidelines for the Use of Video Capsule Endoscopy

Video Capsule Endoscopy (VCE) is the best diagnostic procedure to examine the gastrointestinal tract. It is used in the diagnosis and evaluation of several small bowel conditions.

Although it’s a non-invasive measure, the medical community has determined several clinical guidelines for the use of the Stratis MiroCam Video Capsule Endoscopy System.

Here are the clinical guidelines for the use of mirocam capsule endoscopy:

  1. Video capsule endoscopy of the small bowel is recommended for the patients who present with the clinical features associated with Crohn’s disease and negative ileocolonoscopy, as well as imaging studies.
  2. Video capsule endoscopy is indicated in the patients suffering from Crohn’s disease and the clinical features that are not explained by ileocolonoscopy.
  3. Video capsule endoscopy is suggested in the patients suffering from Crohn’s disease where the assessment of the mucosal healing of the small bowel is required.
  4. Video capsule endoscopy is recommended in patients with suspected small-bowel recurrence of Crohn’s disease post colectomy which is not diagnosed by ileocolonoscopy or other imaging studies.
  5. Video capsule endoscopy is not suggested in the patients suffering from chronic abdominal pain or diarrhea as the symptom and no other evidence of Crohn’s disease.
  6. Video capsule endoscopy is not suggested in the patients who have a suspecion of celiac disease.
  7. Video capsule endoscopy is recommended in the cases presenting with celiac disease along with unexplained symptoms despite taking treatment, as well as appropriate medical assessments..
  8. Video capsule endoscopy is recommended as the following diagnostic step in the cases that present with overt gastrointestinal bleeding (excluding hematemesis) and present negative finding on colonoscopy and EGD.
  9. Video capsule endoscopy is recommended in the patients presenting with overt, obscure bleeding.
  10. VCE, endoscopy, and/or colonoscopy are recommended in the cases with prior negative capsule endoscopy that present with repeated obscure bleeding.
  11. Video capsule endoscopy is indicated in some selected cases where the patient is suspected of obscure gastrointestinal bleeding and unexplained mild chronic iron-deficiency anemia.
  12. Video capsule endoscopy is suggested as a part of ongoing surveillance in the patients presenting with polyposis syndromes who need small-bowel studies.
  13. Video capsule endoscopy is not recommended as the routine substitute for colonoscopy.
  14. Colon capsule is not recommended in the patients presenting with IBD (inflammatory bowel disease). Colonoscopy is suggested for the assessment of the extent, as well as the severity of the disease.
  15. In the patients who are undergoing capsule endoscopy, it is recommended that the consent process should include the disclosure of the susceptibility of a failed procedure, a missed lesion, or capsule retention.
  16. The use of patency capsule prior to VCE is recommended in the patients with confirmed or suspected stricture of small bowel to reduce the risk of capsule retention.
  17. In the patients who complain of poor gastrointestinal mobility or chronic narcotic use, it is recommended to confirm that the capsule has managed to reach the small bowel within one hour of ingestion. It is suggested to continue the study until the battery of the capsule is exhausted completely.
  18. Video capsule endoscopy cannot be performed in the patients who have a pacemaker.
  19. It is suggested to document specific components noted on each report in the patients who are undergoing VCE.
  20. It is suggested that video capsule endoscopy should be performed by professional endoscopists with authorized competency in cognitive and technical aspect of conducting, reporting, as well as, interpreting video capsule endoscopy examinations.