Wireless capsule endoscopy

Wireless capsule endoscopy (WCE, also referred to in this issue as video capsule endoscopy and capsule endoscopy), using the M2A Capsule Endoscope, (Given Imaging Ltd., Yoqneam, Israel), closes the endoscopic gap between push enteroscopy and ileal intubation at colonoscopy and enables physicians to directly view the entire small intestine. WCE is performed most often in patients with obscure gastrointestinal bleeding. Other indications include chronic diarrhea, unexplained abdominal pain, weight loss, and iron deficiency anemia; it is also used to determine the extent of Crohn’s and celiac diseases. I welcomed the opportunity to edit this issue of the Gastrointestinal Endoscopy Clinics of North America. It was not only an exciting labor of love but also a unique opportunity to review the experiences of the esteemed authors with the M2A Capsule Endoscope. This is the initial comprehensive source of this new technology. WCE signals the beginning of a new endoscopic era that is filled with adventures as well as trepidation as we expand our knowledge base. Technological advances have resulted in improvement of our diagnostic armamentarium and, as expected, improved our diagnostic yield. New manifestations of old diseases as well as new diseases are being recognized; we are also seeing earlier stages of diseases. This raises the challenge of diagnosis and the therapeutic questions of which cases to treat and how to treat them. In addition, the natural history of these previously undescribed early lesions is unclear. We are sharpening our interpretative skills, and although the impulse is to run blindly ahead, we are straddled by caution.