RecruitingNot ApplicableNCT06882993

Feasibility of a Minimally Invasive Diagnostic Algorithm in Suspected Crohn's Disease

Feasibility of a Minimally Invasive Diagnostic Algorithm in Suspected Crohn's Disease - a Prospective Comparison of Pan-Enteric Capsule Endoscopy Versus Ileocolonoscopy Plus MR Enterography or Small-Bowel Capsule Endoscopy


Sponsor

Esbjerg Hospital - University Hospital of Southern Denmark

Enrollment

165 participants

Start Date

Feb 26, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to learn whether a camera pill examination of the whole bowel can be used to diagnose Crohn's disease instead of colonoscopy and a small bowel examination (either MRI or camera pill) in patients aged 18-40 years suspected of having Crohn's disease. The main question it aims to answer is: How many patients examined with a camera pill examination of the whole bowel will have a complete examination of the whole bowel and have a diagnosis made without need for any more examinations? Researchers will compare with patients examined with colonoscopy and a small bowel examination. Participants will: * Be examined with either a camera pill examination of the whole bowel, or a colonoscopy and a small bowel examination * Have their electronic medical records checked to see if a diagnosis has been made * Have an interview every three months if diagnosed with an inflammatory bowel disease or after a year if no disease was found


Eligibility

Min Age: 18 YearsMax Age: 40 Years

Inclusion Criteria14

  • Clinical suspicion of CD\*
  • Age 18-40 years
  • Signed informed consent
  • \*A clinical suspicion of CD is based on the following definition:
  • Diarrhea and/or abdominal pain for more than 1 month (or repeated episodes of diarrhea and/or abdominal pain) and either
  • fecal calprotectin ≥ 200 mg/kg or
  • fecal calprotectin ≥ 50 mg/kg plus one or more of the following findings:
  • C-reactive protein (CRP) \> 5 mg/L
  • Thrombocytosis (\> 400 x 109/L)
  • Anemia (hemoglobin \< 7.0 mmol/L for women and \< 8.0 mmol/L for men or a decrease \> 0.5 mmol/L compared to the usual level)
  • Prolonged fever (\> 37.5 ◦C for more than 2 weeks)
  • Weight loss (≥ 3 kg or ≥ 5% compared to the normal body weight)
  • Perianal abscess / fistula
  • Family history of inflammatory bowel disease.

Exclusion Criteria11

  • Previous intestinal resection
  • Positive serologic markers for celiac disease
  • Positive stool polymerase chain reaction for pathogenic bacteria
  • Positive stool polymerase chain reaction for intestinal parasites
  • Suspected or established acute bowel obstruction (ileus)
  • Intake of NSAIDs or acetylsalicylic acid ≤ 4 weeks before inclusion, except low-dose, prophylactic acetylsalicylic acid (≤ 150 mg per day)
  • Intake of opioid or opioid-like medications ≤ 1 week before inclusion
  • Pregnancy or lactation
  • Inability to comply with protocol requirements, e.g. for reasons including alcohol or recreational drug abuse
  • Known gastrointestinal disorder other than functional gastrointestinal disorders
  • Renal failure defined by a plasma-creatinine above the normal reference range

Interventions

DIAGNOSTIC_TESTPanenteric capsule endoscopy

Panenteric capsule endoscopy

DIAGNOSTIC_TESTIleocolonoscopy

Endoscopic examination of the colon and terminal ileum after bowel preparation.

DIAGNOSTIC_TESTMRI enterography

MRI of the small bowel

DIAGNOSTIC_TESTSmall bowel capsule endoscopy

Capsule endoscopy of the small bowel


Locations(5)

Esbjerg Hospital - University Hospital of Southern Denmark

Esbjerg, Denmark

Odense University Hospital

Odense C, Denmark

Odense University Hospital - Svendborg Hospital

Svendborg, Denmark

Lillebaelt Hospital Vejle - University Hospital of Southern Denmark

Vejle, Denmark

Skåne University Hospital

Malmo, Sweden

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NCT06882993


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