Navigating celiac disease with small bowel capsule endoscopy: current state and future horizons.

Celiac disease (CeD) is a widely diffused chronic autoimmune disorder triggered by the ingestion of gluten, in genetically predisposed individuals. Small bowel capsule endoscopy (SBCE) plays a pivotal role as a noninvasive tool for diagnosing and monitoring CeD. This review aims to summarize the current and potential future role of SBCE in the field of CeD.

Bowel preparation for small bowel capsule endoscopy: standard regimen with 2 L polyethylene glycol versus 1 L polyethylene glycol plus ascorbate.

Background/aims: Optimization of bowel preparation for small bowel capsule endoscopy (SBCE) is debated. Guidelines recommend 2 L of iso-osmolar polyethylene glycol (PEG) to improve SBCE visibility. We compared the efficacy of the standard 2 L PEG solution with a 1 L PEG plus ascorbate (PEG-ASC) preparation, which has already been established for large-bowel preparation.

Effect of antithrombotic therapies on small bowel bleeding: an European multicenter retrospective study.

Background/aims: Small bowel bleeding (SBB) is the main indication for videocapsule endoscopy (VCE); the diagnostic yield (DY) could be influenced by antithrombotic therapies. We explored the effects of these therapies on SBB.

Methods: Consecutive patients from two centers (Milan, Italy and Sheffield, UK) who underwent VCE between March 2001 and July 2020 were considered.

Computer aided villi morphometric quantification in video-capsule enteroscopy: A newly developed software to quantify small bowel atrophy.

Background And Aims: Small bowel capsule endoscopy (SBCE) has an established role in patients with non-responsive celiac disease (CeD). A non-invasive method to quantify small bowel atrophy is still lacking.

Methods: We analysed SBCE frames from CeD patients from 2018 to 2020.

Incomplete small bowel capsule endoscopy: Risk factors and cost-effectiveness of real-time viewing.

International guidelines recommend real-time viewing (RTV) in capsule endoscopy for gastric emptying monitoring, yet it is often overlooked in clinical practice. We aimed to assess risk factors for incomplete small bowel capsule endoscopy (SBCE) and evaluate the clinical relevance and cost-effectiveness of RTV implementation. We included consecutive SBCEs from 2013 to 2020.

The carbon cost of inappropriate endoscopy.

Background And Aims: Digestive endoscopy is a resource-intensive activity with a conspicuous carbon footprint and an estimated rate of inappropriateness. However, the carbon costs of inappropriate endoscopic procedures still remain obscure. Here we evaluated the environmental impact of inappropriate endoscopic examinations.

Dual X-ray absorptiometry-derived bone status indexes and videocapsule intestinal aspects in celiac disease.

Background And Aim: Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status.

Methods: We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019.

Clinical impact of videocapsule endoscopy and device-assisted enteroscopy in non-bleeding small bowel lesions.

Background: Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting.

Objectives: We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period.

Biomarkers for the diagnosis and monitoring of celiac disease: can you count on me?

Purpose Of Review: Different markers are available to diagnose and monitor celiac disease (CeD); however, the concordance among them and their efficacy are still controversial. We aim at defining the efficacy of CeD biomarkers, their advantages and limits.

Recent Findings: CeD diagnostic criteria are widely accepted, being a positive serology and duodenal atrophy (according to the Marsh-Oberhuber score) the main hallmarks.

Clinical impact of videocapsule and double balloon enteroscopy on small bowel bleeding: Results from a large monocentric cohort in the last 19 years.

Background: Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy (VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities in a large cohort of SSBB patients in a European tertiary center.

Methods: We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or DBE from March 2001 to July 2020.

How to manage celiac disease and gluten-free diet during the COVID-19 era: proposals from a tertiary referral center in a high-incidence scenario.

The outbreak of COVID-19 and SARS-CoV-2 infection is spreading worldwide as the first coronavirus pandemic. The clinical picture is variable but flu-like symptoms are common with bilateral interstitial pneumonia being the most frightening presentation. No specific therapies nor vaccine have been developed to date and the only way to limit the virus diffusion is by modifying one's lifestyle limiting social life and following strict hygienic precautions.

Endoscopy during the Covid-19 outbreak: experience and recommendations from a single center in a high-incidence scenario.

A dramatic SARS-Cov-2 outbreak is hitting Italy hard. To face the new scenario all the hospitals have been re-organised in order to reduce all the outpatient services and to devote almost all their personnel and resources to the management of Covid-19 patients. As a matter of fact, all the services have undergone a deep re-organization guided by: the necessity to reduce exams, to create an environment that helps reduce the virus spread, and to preserve the medical personnel from infection.

Protein-losing enteropathy.

Purpose Of Review: The present review offers its readers a practical overview of protein-losing enteropathy, particularly with regard to diagnostic and therapeutic approaches. The aim is to support clinicians in their daily practice with a practical tool to deal with protein-losing enteropathy.

Recent Findings: The literature covering protein-losing enteropathy does not appear to be quite recent and also guidelines are scanty.