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Mayo Clinic Finds Capsule Endoscopy Can Detect Intestinal Damage Caused By Celiac Disease
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
http://www.mayoclinic.org/celiac-disease.
Mayo Clinic
http://www.mayoclinic.org
Clinica Mayo constatã capsulei endoscopice poate detecta intestinale daune cauzate de boalã Celiac - Mayo Clinic Finds Capsule Endoscopy Can Detect Intestinal Damage Caused By Celiac Disease - articole medicale engleza - startsanatate