Double-balloon enteroscopy in Crohn’s disease patients suspected of small bowel activity: findings and clinical impact
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It is estimated that 10–30% of patients with Crohn’s disease (CD) have small bowel (SB) involvement, but the exact frequency and clinical relevance of these findings is unknown. Double-balloon enteroscopy (DBE) enables endoscopic visualization of the SB. In this study we evaluated whether DBE is a feasible technique for detection of CD localized in the SB in CD patients with clinical suspicion of SB lesions and whether these findings have clinical impact.
Retrospectively we analyzed 52 DBE procedures in 40 CD patients (16 males, mean age 40 years, mean duration of CD 15 years). Included patients had clinical suspicion of small bowel CD activity, including persistent abdominal discomfort (n = 27), iron deficiency anemia (n = 9) and/or hypomagnesemia (n = 4).
Active small bowel CD was found in 24 (60%) patients, leading to a change in therapy in 18 patients (75%). After a mean follow-up of 13 months, 15 (83%) had persistent clinical improvement with a significant drop of mean CDAI from 178 to 90, after a mean follow-up of 13 months.
DBE is a useful diagnostic tool for the evaluation of SB lesions in CD patients. The significance of these findings is emphasized by the fact that adjustment of therapy in the majority of these patients leads to significant and sustained clinical improvement.
KeywordsCrohn’s disease Small bowel Enteroscopy Double-balloon enteroscopy
- 5.Wolters FL, Russel MG, Sijbrandij J, et al. (on behalf of the European Collaborative Study Group on Inflammatory Bowel Disease (EC-IBD). Disease outcome of inflammatory bowel disease patients: General outline of a Europe-wide opulationbased 10-year clinical follow-up study. Scand J Gastroenterol (Suppl). 2006;243:46–54.Google Scholar
- 21.Mergener K, Enns R, Brandabur JJ, et al. Complications and problems with capsule endoscopy: results from two referral centers. Gastrointest Endosc. 2003;AB57:170.Google Scholar