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diarrhea without any evidence of elevated biomarkers. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines recommend that CE is the preferred initial diagnostic option for the evaluation of the small intestine in patients presenting suspected CD and demonstrating negative ileocolonoscopic examination in the absence of obstructive symptoms or radiological stenosis. ESGE also recommends that careful patient selection based on careful assessment of clinical symptoms and serological or fecal inflammatory biomarkers is an important factor to improve the diagnostic accuracy and yield of CE in in patients presenting with suspected CD. ESGE recommends the use of radiological imaging such as CT enterography or MR enterography, to investigate the extent of CD and/or extraluminal involvement in patients with a known diagnosis of CD. The current issue of Intestinal Research has published a report by Kim et al. describing a retrospective study focusing on the current practice pattern for CE in patients with suspected CD or those with established CD. In this study, the overall diagnostic yield of a CE was 59.7% (34/57) in patients with suspected CD, and 28.1% patients (16/57) were diagnosed with CD based on CE findings. A recent metaanalysis showed that the diagnostic yield of CE in patients with suspected CD was significantly higher than that of a small bowel follow through (SBFT), enteroclysis and CT enterography (CE 52% vs. SBFT/small bowel enteroclysis 16% and incremental yield 32%; P<0.001; 95% CI, 16%–48%: CE 68% vs. CT enterography 21% and incremental yield 47%; P<0.001; 95% CI, 31%–63%). Tukey et al. reported that careful patient selection based on the International ConferCapsule endoscopy (CE) and balloon-assisted enteroscopy are advanced diagnostic and therapeutic modalities used for the management of suspected small bowel disease. CE is a noninvasive and sensitive option to evaluate the small intestine in patients presenting obscure gastrointestinal bleeding, CD, polyposis syndromes, celiac disease, or other suspected small intestinal diseases. CD is a chronic IBD that may affect any part of the gastrointestinal tract; the incidence of CD of the small intestine is approximately 40% to 60%. CD is diagnosed based on a combination of endoscopic, radiological, histological and biochemical evaluation, as well as clinical symptoms. A recent clinical guideline in Canada suggests that CE is recommended for patients presenting clinical symptoms compatible with CD, in the presence of a negative ileocolonoscopic examination and radiological studies. CE is also recommended in established CD patients showing clinical symptoms that are unexplained by an ileocolonoscopic examination or radiological studies. CE is recommended in established CD patients to assess small intestinal mucosal healing. CE is needed in patients in whom ileocolonoscopic examination and/or radiological studies might not successfully detect the recurrence of small bowel CD after a colectomy. This guideline in Canada suggests that CE is not

Role of capsule endoscopy in suspected or established Crohn's disease in real practice