In early 2000, small bowel capsule has been a breakthrough for small bowel diagnosis. With a couple years it became a gold standard. Initiated by Given imaging (now Medtronic) then follow by multiple competitors with minimal technically changes but with overall same results. Improvements rely on longer-lasting batteries, wider angle of view, better resolution and easier handling. The more concrete improvements rely on new software with better detection based on mathematical algorithms in order to reduce boring reading time.

The main indications are obscure GI bleeding and suspected Crohn’s disease. It could also be used for familial polyposis or celiac disease. A new indication is currently under investigation, capsule endoscopy for non-hematemesis GI bleeding in some intensive care unit before gastroscopy. Artificial intelligence is also another important improvement as a computer is able to diagnose actually all small bowel abnormalities; In digestive endoscopy it is a unique situation where the machine is clearly better than the physician.

Future development relies on a new technology of magnetic guidance. Esophagus and stomach could be examined in similar ways than gastroscopy. The first clinical trial was carried on in our unit by Olympus and Siemens in cooperation with three Japanese universities. Ankon since then marked a very effective guidance system in China.

Artificial intelligence is also adding in this future project by Omom Jinshan with a Robot
capsule able to perform by its own gastric examination with a full upper GI examination in case of non hematemesis bleeding
Capsule endoscopy is a major improvement gastrointestinal field. the only drawback is its cost but we could expect a more affordable capsule with a larger use.