Panenteric Capsule Endoscopy in Young Patients with Suspected Irritable Bowel Syndrome: A Self-Controlled Feasibility Study.

Objective: Although the diagnosis of irritable bowel syndrome (IBS) is based on clinical criteria, a colonoscopy is often performed to rule out alternative digestive disorders. The panenteric PillCam™ Crohn's capsule, which allows non-invasive examination of both the small bowel and the colon, may be an alternative investigation. We aimed to evaluate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS as an alternative to the classical approach based on colonoscopy. Design: Of 42 consecutive adults aged 18-50 years with symptoms consistent with IBS for more than 6 months, 33 were enrolled, and 27 received both routine biological tests, fecal calprotectin, panenteric capsule, and gastrointestinal endoscopies. Results: All 21 lesions identified by the capsule in 15 patients were unrelated to digestive symptoms, as were the 11 lesions identified by colonoscopy in 7 patients, and all were of little or no clinical interest. In addition, one gastric ulcer and one gastric MALT lymphoma diagnosed only by systematic gastric biopsy were characterized by upper endoscopy. The capsule was preferred by all patients to the classical endoscopic procedures. Conclusion: The diagnosis of IBS was not called into question in any of the patients explored. These preliminary results demonstrate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS.