Video Capsule Endoscopy in Lynch Syndrome

Lynch syndrome is characterized by mismatch repair gene mutations. People who are known mutation carriers are recommended to undergo colonoscopy every 1 to 2 years, and interval upper endoscopy is often practiced, or at least an initial upper endoscopy with biopsies for Helicobacter pylori and eradication if infection is present. Clinicians often wonder whether patients should undergo small-bowel examinations, because the relative risk for small-bowel cancer is substantially increased in Lynch syndrome, although the absolute risk is low.

In this prospective study from the Netherlands, 200 patients with proven mutations (MSH6, 76 patients; MSH2, 68; MLH1, 50; PMS2, 3; EPCAM, 3) underwent video capsule endoscopy (VCE). VCE identified one duode…