ArticleClinical and translational gastroenterology2011
Capsule endoscopy: a valuable tool in the follow-up of people with celiac disease on a gluten-free diet.
Article in Clinical and translational gastroenterology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Younger age at diagnosis predisposes to mucosal recovery in celiac disease on a gluten-free diet: A meta-analysis.PloS one · 2017Pooled it
- Evaluating Responses to Gluten Challenge: A Randomized, Double-Blind, 2-Dose Gluten Challenge Trial.Gastroenterology · 2021Trial
- Guidelines for best practices in monitoring established coeliac disease in adult patients.Nature reviews. Gastroenterology & hepatology · 2024Review
- Quantification of Celiac Disease Severity Using Video Capsule Endoscopy: A Comparison of Human Experts and Machine Learning Algorithms.Current medical imaging · 2023Article
- Small bowel capsule endoscopy in refractory celiac disease: a luxury or a necessity?Annals of gastroenterology · 2021Article
- Small bowel capsule endoscopy: Where are we after almost 15 years of use?World journal of gastrointestinal endoscopy · 2015Review
- Assessment of the response to gluten-free diet in an Iraqi population with coeliac disease. A histological and serological follow-up study.Archives of medical science : AMS · 2014Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTraditional celiac disease guidelines recommend follow-up endoscopy and duodenal biopsies at 6-12 months after commencing a gluten-free diet (GFD). However, histology may remain abnormal even 1-2 years later. We evaluated the role of capsule endoscopy in patients with celiac disease after treatment with a GFD.
methodsTwelve adult patients with newly diagnosed celiac disease were prospectively enrolled. All patients had baseline symptom assessment, celiac serology (tissue transglutaminase antibody, tTG), and capsule endoscopy. Twelve months after commencing a GFD, patients underwent repeat symptom assessment, celiac serology, upper gastrointestinal endoscopy, and capsule endoscopy.
resultsAt baseline, capsule endoscopy detected endoscopic markers of villous atrophy in the duodenum and extending to a variable distance along the small intestine. On the basis of small bowel transit time, the mean±s.e.m. percentage of small intestine with villous atrophy was 18.2±3.7%. After 12 months on a GFD, repeat capsule endoscopy demonstrated mucosal healing from a distal to proximal direction, and the percentage of small intestine with villous atrophy was significantly reduced to 3.4±1.2% (P=0.0014) and this correlated with improvement in the symptom score (correlation 0.69, P=0.01). There was a significant improvement in symptom score (5.2±1.0 vs. 1.7±0.4, P=0.0012) and reduction in immunoglobulin A-tTG levels (81.5±10.6 vs. 17.5±8.2, P=0.0005). However, 42% of subjects demonstrated persistent villous abnormality as assessed by duodenal histology.
conclusionsAfter 12 months on a GFD, patients with celiac disease demonstrate an improvement in symptoms, celiac serology, and the extent of disease as measured by capsule endoscopy. Mucosal healing occurs in a distal to proximal direction. The extent of mucosal healing correlates with improvement in symptoms. Duodenal histology does not reflect the healing that has occurred more distally.
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Registered trials
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