Mayo Clinic Finds Capsule Endoscopy Can Detect Intestinal Damage Caused by Celiac Disease

Study shows extent of intestinal damage does not explain patients'

symptoms







27 Feb, 2008, 00:00 ET from Mayo Clinic

    ROCHESTER, Minn., Feb. 27 /PRNewswire-USNewswire/ -- Mayo Clinic
 researchers have found that capsule endoscopy can provide a magnified view
 of the intestinal damage caused by celiac disease. This new information can
 help physicians detect and diagnose celiac disease, as well as measure
 intestinal healing following treatment. These findings are published in
 this month's issue of Clinical Gastroenterology and Hepatology.
 
 
 
     Approximately 3 million Americans, or about one in 100 people, are
 affected by celiac disease. Individuals who have celiac disease are
 intolerant to proteins (collectively called gluten) found in wheat, barley
 and rye grains. In these people, gluten stimulates an immune reaction in
 the small intestine, which causes intestinal damage and the subsequent
 inability to absorb certain nutrients from food. Treatment is to avoid
 foods containing gluten (the so-called gluten-free diet). Untreated, celiac
 disease can cause many medical complications and increase the risk of
 death. However, when a medically supervised diet plan is implemented,
 patients can experience almost complete reversal of symptoms and
 complications from the disease.
 
 
 
     "Capsule endoscopy allows us to look at the entire 30 feet of the small
 intestine, not just the first one to two feet that can be visualized with
 other types of endoscopy," says Joseph Murray, M.D., the study's lead
 author and a gastroenterologist at Mayo Clinic.
 
 
 
     The capsule is approximately the size of a large vitamin, and it
 includes a miniature color video camera, light, battery and transmitter.
 The patient swallows the capsule, which takes approximately eight hours to
 move through the small intestine. As the capsule moves through the
 digestive tract, images recorded by the video camera are transmitted to a
 number of sensors attached to the patient's torso and recorded digitally on
 a device worn around the patient's waist. Then, the recording device is
 removed and its contents are downloaded to a computer for examination.
 
 
 
     This study, the first of its kind, used capsule endoscopy to view
 intestinal damage in 37 patients with untreated, biopsy-proven celiac
 disease. Ninety-two percent had visible damage detected by capsule
 endoscopy. Twenty-two patients had extensive damage in the duodenum (first
 portion of the small intestine) and patchy damage throughout the jejunum
 (the small intestine's middle portion). Twelve patients had damage limited
 to the duodenum, and one patient had only patchy damage throughout the
 jejunum. However, no association was shown between the extent of intestinal
 damage and the patients' symptoms. Six months after a gluten-free diet was
 implemented, capsule endoscopy showed improvement, or decreased intestinal
 damage, in most patients.
 
 
 
     "This study confirmed our suspicions that the most extensive intestinal
 damage in celiac disease patients is primarily to the duodenum. However, we
 were surprised to discover no correlation between extent of intestine
 damage and patient symptoms," says Dr. Murray. "Capsule endoscopy will now
 be another tool to diagnose celiac disease and detect intestinal damage
 both prior to and following treatment."
 
 
 
     Other members of the Mayo Clinic research team included Alberto Rubio
 Tapia, M.D., Carol Van Dyke, Deanna Brogan, Mary Knipschield, Brian Lahr,
 Ashwin Rumalla, Alan Zinsmeister, Ph.D., and Christopher Gostout, M.D.
 
 
 
     Each year, physicians at Mayo Clinic's campuses in Arizona, Florida and
 Minnesota treat hundreds of patients who have celiac disease. For more
 information on celiac disease treatment at Mayo Clinic, visit
 www.mayoclinic.org/celiac-disease/.
 
 
 
     To obtain the latest news releases from Mayo Clinic, go to
 www.mayoclinic.org/news. MayoClinic.com (www.mayoclinic.com) is available
 as a resource for your health stories.
 
 
 
 
 
 
 

SOURCE Mayo Clinic
    ROCHESTER, Minn., Feb. 27 /PRNewswire-USNewswire/ -- Mayo Clinic
 researchers have found that capsule endoscopy can provide a magnified view
 of the intestinal damage caused by celiac disease. This new information can
 help physicians detect and diagnose celiac disease, as well as measure
 intestinal healing following treatment. These findings are published in
 this month's issue of Clinical Gastroenterology and Hepatology.
 
 
 
     Approximately 3 million Americans, or about one in 100 people, are
 affected by celiac disease. Individuals who have celiac disease are
 intolerant to proteins (collectively called gluten) found in wheat, barley
 and rye grains. In these people, gluten stimulates an immune reaction in
 the small intestine, which causes intestinal damage and the subsequent
 inability to absorb certain nutrients from food. Treatment is to avoid
 foods containing gluten (the so-called gluten-free diet). Untreated, celiac
 disease can cause many medical complications and increase the risk of
 death. However, when a medically supervised diet plan is implemented,
 patients can experience almost complete reversal of symptoms and
 complications from the disease.
 
 
 
     "Capsule endoscopy allows us to look at the entire 30 feet of the small
 intestine, not just the first one to two feet that can be visualized with
 other types of endoscopy," says Joseph Murray, M.D., the study's lead
 author and a gastroenterologist at Mayo Clinic.
 
 
 
     The capsule is approximately the size of a large vitamin, and it
 includes a miniature color video camera, light, battery and transmitter.
 The patient swallows the capsule, which takes approximately eight hours to
 move through the small intestine. As the capsule moves through the
 digestive tract, images recorded by the video camera are transmitted to a
 number of sensors attached to the patient's torso and recorded digitally on
 a device worn around the patient's waist. Then, the recording device is
 removed and its contents are downloaded to a computer for examination.
 
 
 
     This study, the first of its kind, used capsule endoscopy to view
 intestinal damage in 37 patients with untreated, biopsy-proven celiac
 disease. Ninety-two percent had visible damage detected by capsule
 endoscopy. Twenty-two patients had extensive damage in the duodenum (first
 portion of the small intestine) and patchy damage throughout the jejunum
 (the small intestine's middle portion). Twelve patients had damage limited
 to the duodenum, and one patient had only patchy damage throughout the
 jejunum. However, no association was shown between the extent of intestinal
 damage and the patients' symptoms. Six months after a gluten-free diet was
 implemented, capsule endoscopy showed improvement, or decreased intestinal
 damage, in most patients.
 
 
 
     "This study confirmed our suspicions that the most extensive intestinal
 damage in celiac disease patients is primarily to the duodenum. However, we
 were surprised to discover no correlation between extent of intestine
 damage and patient symptoms," says Dr. Murray. "Capsule endoscopy will now
 be another tool to diagnose celiac disease and detect intestinal damage
 both prior to and following treatment."
 
 
 
     Other members of the Mayo Clinic research team included Alberto Rubio
 Tapia, M.D., Carol Van Dyke, Deanna Brogan, Mary Knipschield, Brian Lahr,
 Ashwin Rumalla, Alan Zinsmeister, Ph.D., and Christopher Gostout, M.D.
 
 
 
     Each year, physicians at Mayo Clinic's campuses in Arizona, Florida and
 Minnesota treat hundreds of patients who have celiac disease. For more
 information on celiac disease treatment at Mayo Clinic, visit
 www.mayoclinic.org/celiac-disease/.
 
 
 
     To obtain the latest news releases from Mayo Clinic, go to
 www.mayoclinic.org/news. MayoClinic.com (www.mayoclinic.com) is available
 as a resource for your health stories.
 
 
 
 
 
 
 SOURCE Mayo Clinic