According to a study released on July 9, 2008 in the Journal of Pediatric Gastroenterology and Nutrition, PillCam capsule endoscopy in the small intestines may improve Crohn’s Disease treatment regimens in children by assisting in appropriate classification of inflammatory bowel diseases.

Inflammatory bowel diseases (IBD) are a set of chronic inflammatory diseases of the intestinal tract. They cause a variety of symptoms, including abdominal pain, diarrhea and rectal bleeding, usually manifested in constant cycles of flare-ups and remission. There are two major types of IBD: Crohn’s Disease and ulcerative colitis.  The former is characterized by ulcers, and inflammation in the innermost lining of the large intestine or colon and the rectum. Crohn’s Disease, sometimes called ileitis or enteritis, is a gastrointestinal disorder which is indicated by chronic inflammation of the wall of any part digestive tract, but is usually centered in the small intestine’s ileum.

PillCam capsule endoscopy involves ingestion of a small capsule, similar to the size of a vitamin. This capsule contains a small camera that transmits images which are reviewed by a physician afterwards. The physician monitors the small bowel mucosa to find abnormalities that could indicate the presence of Crohn’s or ulcerative colitis.

Stanley Cohen, M.D., of the Children’s Center for Digestive Healthcare in Atlanta, Georgia investigated the effects experienced by PillCam users already diagnosed with IBD. A retrospective cohort study was performed, analyzing the medical records of patients between the ages of 2 and 12 years who had been diagnosed previously with Crohn’s disease, ulcerative colitis, or indetermintate colitis, with flareups in the previous three years, who had thus been analyzed with capsule endoscopy. In total, 28 patients were included in the study.

Of the 7 patients with ulcerative or indeterminate colitis, 5 (71%) were found to have additional lesions and thus reclassified as Crohn’s patients. This resulted in a change in medical management. Of the 21 patients initially diagnosed with Crohn’s disease, 13 (62%) were found to have further disease than previously identified. Of these, 92% occurred in the jejunum, which may suggest that pediatric Crohn’s disease involves the proximal small bowel more than previously reported. Based on this, 92% of treatment regimens were modified based on these results.

“PillCam SB is a valuable tool that allows gastroenterologists to make better medical decisions and tailor pharmacological management, resulting in improved patient outcomes for those who suffer from IBD,” said Dr. Cohen. “Information obtained through PillCam SB capsule endoscopy can enable us to reclassify disease or understand the full extent to which the disease is affecting patients, thus facilitating more targeted and effective treatment regimens.” The authors also pointed out that this sort of analysis often helps patients and their parents understand the progression of the disease and reasons for various recommendations.  

About Given Imaging Ltd.

Given Imaging is redefining gastrointestinal diagnosis by developing, producing and marketing innovative, patient-friendly products for detecting gastrointestinal disorders. The company’s technology platform is the PillCam(R) Platform, featuring the PillCam video capsule, a disposable, miniature video camera contained in a capsule, which is ingested by the patient, a sensor array, data recorder and RAPID(R) software. Given Imaging has a number of available capsules: the PillCam SB video capsule to visualize the entire small intestine which is currently marketed in the United States and in more than 60 other countries; the PillCam ESO video capsule to visualize the esophagus; the Agile(TM) patency capsule to determine the free passage of the PillCam capsule in the GI tract and the PillCam COLON video capsule to visualize the colon that has been cleared for marketing in the European Union. PillCam COLON has received a CE Mark, but is not cleared for marketing or available for commercial distribution in the USA. More than 700,000 patients worldwide have benefited from the PillCam capsule endoscopy procedure. Given Imaging’s headquarters, manufacturing and R&D facilities are located in Yoqneam, Israel. It has operating subsidiary companies in the United States, Germany, France, Japan, Australia and Singapore. Given Imaging’s largest shareholders include Elron Electronic Industries (NASDAQ & TASE: ELRN). For more information, visit http://www.givenimaging.com.

Capsule Endoscopy May Reclassify Pediatric Inflammatory Bowel Disease: A Historical Analysis.
Cohen, Stanley A; Gralnek, Ian M; Ephrath, Hagit; Saripkin, Larry; Meyers, William; Sherrod, Olga; Napier, Angela; Gobin, Tamara
Journal of Pediatric Gastroenterology & Nutrition. 47(1):31-36, July 2008.
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Written by Anna Sophia McKenney