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
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
• 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.