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It specifies when VCE should be funded after failed conventional endoscopy and when BE is indicated for further investigation or therapy following VCE or cross-sectional imaging. It details recommended pathways for obscure GI bleeding, iron-deficiency anaemia, suspected Crohn’s disease, small-bowel tumours, inherited polyposis syndromes, and coeliac disease, including guidance on follow-up after VCE and non-routine second-look endoscopy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/video-capsule-endoscopy-and-balloon-enteroscopy-for-small-bowel-investigation-v-1-1-policy/315949/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/video-capsule-endoscopy-and-balloon-enteroscopy-for-small-bowel-investigation-v-1-1-policy/315949.png","ImageObject",300,407,{"name":92,"@type":93},"Aladdin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"When should VCE be funded for small bowel investigation?","Question",{"text":112,"@type":113},"VCE should normally be funded only when small-bowel investigation is indicated and conventional endoscopy has not successfully identified the problem. Patient or clinician preference is not an indication.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"When is BE recommended after VCE or cross-sectional imaging?",{"text":117,"@type":113},"BE should normally be funded when further investigation and/or treatment of the small bowel is indicated after VCE or after cross-sectional imaging such as CT or MRI. BE may also follow positive VCE results or when endotherapy is required.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the recommended diagnostic pathway in suspected Crohn’s disease?",{"text":121,"@type":113},"For suspected Crohn’s disease, ileocolonoscopy is the recommended first-line diagnostic examination. VCE is recommended next when ileocolonoscopy is inconclusive, and BE may be used for follow-up of positive VCE results or when endotherapy is indicated.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},315949,1790186213,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39},2336478503145,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| Policy title | Video capsule endoscopy and balloon enteroscopy for small bowel investigation v1 .1 |\n| --- | --- |\n| Policy position | Criteria Based Access |\n| Date of CCG recommendation | February 2021 |\n\nVideo capsule endoscopy (VCE) , also known as wireless capsule endoscopy , enables imaging of the entire small bowel using a video capsule which is swallowed by the patient.  \nBalloon enteroscopy (BE) , including single-balloon enteroscopy and double-balloon enteroscopy , allows deep intubation of the small bowel. BE allows real-time visualisation and can be used to perform endoscopic therapy but it is a more invasive technique which requires sedation or general anaesthetic.  \n• VCE should normally only be funded where investigation of the small bowel is indicated and where conventional endoscopy has not been successful in identifying the problem.  \n• BE should normally only be funded where further investigation and/or treatment of the small bowel is indicated after VCE or cross-sectional imaging (i.e. CT or MRI) .  \nRecommended utilisation  \nPatient or clinician preference is not an indication for the use of VCE.  \nObscure gastro intestinal bleeding (OGIB) and iron-deficiency anaemia  \n• In OGIB and iron-deficiency anaemia, where bleeding is occult and the condition is unresponsive to medical treatment (i.e. iron supplementation for three months) and upper and lower gastrointestinal endoscopies are inconclusive, VCE is recommended for initial investigation with BE to be considered for follow up if necessary.  \n• In OGIB cases with overt (visible) bleeding or in patients unable to tolerate iron therapy offer VCE as soon as possible. See Figure 1 for more detail.  \n• Follow-up after VCE in OGIB patients: negative small-bowel VCE results should normally be followed by conservative management since re-bleed rates are low in this group; in those with positive small-bowel VCE results, further investigation and treatment may include BE. See Figure 1 for more detail on the recommended approach.  \n\n|  | • It is not recommended to perform‘second-look endoscopy’ routinely before VCE, although for both OGIB and iron-deficiency anaemia, the decision to perform secondlook endoscopy before VCE should be made on a case-by-case basis.\u003Cbr>Crohn’s disease\u003Cbr>• In patients with suspected Crohn’s disease, the recommended first line of diagnostic endoscopic examination is ileocolonoscopy. VCE is recommended asthe next line of diagnostic investigation, where ileocolonoscopy is inconclusive. BE may be used to follow up positive VCE results or where endotherapy is indicated.\u003Cbr>Small bowel tumours\u003Cbr>• Early use of VCE is recommended in the search for small bowel tumours when OGIB and iron-deficiency anaemia are not explained otherwise. BE may be used as a follow-up if imaging tests have already shown suspicion of small-bowel tumour.\u003Cbr>Inherited polyposis syndromes\u003Cbr>• In familial adenomatous polyposis, surveillance is best performed using conventional endoscopes. Use of VCE or BE may be considered where further small-bowel investigation is shown to be clinically indicated.\u003Cbr>Coeliac disease\u003Cbr>• Capsule endoscopy should not normally be used for suspected coeliac disease. However, in cases of non-responsive or refractory coeliac disease (i.e. where signs and symptoms persist after 6 months of a gluten-free diet), VCE should be used for initial investigation and may be followed up by BE where VCE shows abnormalities which need further investigation. |  |\n| --- | --- | --- |\n| NOTE:\u003Cbr>• This policy will be reviewed in the light of new evidence or new national guidance e.g. from NICE\u003Cbr>• Where a patient does not meet the policy criteria or the intervention is not normally funded by the NHS, an application for clinical exceptionality can be considered via the ICB’s Individual Funding Request (IFR) Policy and Process\u003Cbr>Clinical coding:\u003Cbr>OPCS Codes\u003Cbr>G802 Wireless capsule endoscopy\u003Cbr>G803 Diagnostic endoscopic balloon examination of ileum\u003Cbr","cbCaimRjmohkbNX1","https://ap.wps.com/l/cbCaimRjmohkbNX1","pdf",183531,"English","# Policy position\n## Criteria for funding VCE and BE\n## Recommended utilisation\n### Obscure GI bleeding and iron-deficiency anaemia\n### Crohn’s disease\n### Small bowel tumours\n### Inherited polyposis syndromes\n### Coeliac disease\n## Notes and clinical coding","[{\"question\":\"When should VCE be funded for small bowel investigation?\",\"answer\":\"VCE should normally be funded only when small-bowel investigation is indicated and conventional endoscopy has not successfully identified the problem. Patient or clinician preference is not an indication.\"},{\"question\":\"When is BE recommended after VCE or cross-sectional imaging?\",\"answer\":\"BE should normally be funded when further investigation and/or treatment of the small bowel is indicated after VCE or after cross-sectional imaging such as CT or MRI. BE may also follow positive VCE results or when endotherapy is required.\"},{\"question\":\"What is the recommended diagnostic pathway in suspected Crohn’s disease?\",\"answer\":\"For suspected Crohn’s disease, ileocolonoscopy is the recommended first-line diagnostic examination. VCE is recommended next when ileocolonoscopy is inconclusive, and BE may be used for follow-up of positive VCE results or when endotherapy is indicated.\"}]","Video capsule endoscopy and balloon enteroscopy for small bowel investigation - v 1 -1 - Policy | PDF",1789908387]