Indications and Contraindications of Small-bowel Capsule Endoscopy

The indications of small-bowel capsule endoscopy include obscure gastrointestinal bleeding, Crohn’s disease, small-bowel tumors, and polyposis syndrome. Capsule endoscopy is recommended as the first-line investigation in patients with obscure gastrointestinal bleeding. To maximize the diagnostic yield for obscure gastrointestinal bleeding, capsule endoscopy should be performed as soon as possible after the bleeding episode. The risk of capsule retention is increased in patients with Crohn’s disease, previous abdominal surgery, intestinal ischemia, volvulus, and previous abdominal radiotherapy. When stenosis or obstruction is suspected, patency capsule or careful examination using cross-sectional imaging modalities such as magnetic resonance imaging or CT should be considered first.