"Capsule endoscopy is a modern diagnostic method that allows painless and non-invasive examination of the digestive tract using a small capsule," says Michal Voška, MD, PhD, head of the gastroenterology department at Hořovice Hospital.
Is this examination already a standard examination or is it a novelty?
The thin-blood capsule was first introduced in 1999. In 2001, the PillCam SB capsule was approved by the US Food and Drug Administration (FDA). In the same year, the capsule was approved for use in Europe. And already in 2002, the first testing of the thin-blood capsule was carried out in the Czech Republic.
The PillCam Colon capsule endoscopy, the only system in use to date, was introduced in 2006. The second generation capsule is currently in use. A new capsule is the PillCam Crohn's capsule for examination of the mucosa of the small and large intestine. It is the first panenteroscopic test to monitor the activity of non-stenotic Crohn's disease.
Do you now use capsule endoscopy more often than conventional endoscopy?
Small bowel capsule endoscopy is used more frequently in the diagnosis of small bowel disease than classical enteroscopy, which serves more as a therapeutic method, because of its non-invasiveness. In indicated cases, the small bowel capsule is covered by public health insurance. In contrast, the colonic capsule is a complementary examination of the colon, where colonoscopy remains the gold standard.
Your scientific papers deal with the application of capsule enteroscopy and colonoscopy in practice. Yet more people are still undergoing conventional colonoscopy. Why isn't capsule colonoscopy the first diagnostic choice?
Unfortunately, capsule endoscopy does not allow for histological examination. Patients with positive findings must therefore undergo a conventional colonoscopy. Another limitation is the cost of the examination, which is not covered by public health insurance. On the other hand, this method could appeal to the part of the population that is afraid of invasive colonoscopy and therefore does not go for screening.
How many examinations have you already carried out?
I have performed dozens of colonic and thin-blood capsule examinations. The colonic capsule and its use in colorectal cancer screening is the subject of my dissertation. I am a co-author of the recommended procedures of the Czech Gastroenterological Society for capsule endoscopy.
