Endoscopic Intervention in Inflammatory Bowel Disease

  • Fumihito Hirai
  • Toshiyuki Matsui


Today, since we have balloon-assisted enteroscope (BAE) for small intestine, it is possible to perform endoscopic treatment for various small-bowel disorders. In this chapter, we describe endoscopic interventions for small-bowel disorders, particularly inflammatory bowel diseases.

Patients with Crohn’s disease sometimes have massive bleeding that requires transfusion or surgery. In cases where the bleeding point can be detected endoscopically, which is relatively rare, endoscopic small-bowel hemostasis is performed using BAE.

BAE enables endoscopic balloon dilation (EBD) to be performed even for deeply situated strictures of the small intestine. EBD is indicated for small-bowel tumors and inflammatory diseases such as Crohn’s disease (CD), NSAID-induced enteropathy, intestinal tuberculosis, and chronic non-specific multiple ulcers of small intestine to avoid surgery. EBD for small-bowel disorders seems to be quite effective according to short-term analysis of many reports.

A well-designed prospective study is necessary to confirm the long-term efficacy and safety of EBD.


Balloon-assisted enteroscopy Endoscopic interventions Endoscopic hemostasis Endoscopic mucosal resection Endoscopic balloon dilation 


  1. 1.
    Yamamoto H, Kita H, Sunada K, Hayashi Y, Sato H, Yano T, Iwamoto M, Sekine Y, Miyata T, Kuno A, Ajibe H, Ido K, Sugano K. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol. 2004;2:1010–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Bourreille A, Ignjatovic A, Aabakken L, Loftus EV, Eliakim R, Pennazio M, Bouhnik Y, Seidman E, Keuchel M, Albert JG, et al. Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus. Endoscopy. 2009;41:618–37.CrossRefPubMedGoogle Scholar
  3. 3.
    Sugano K, Marcon N. The first international workshop on double balloon endoscopy: a consensus meeting report. Gastrointest Endosc. 2007;66(Suppl):S7–S11.CrossRefPubMedGoogle Scholar
  4. 4.
    Raju GS, Gerson L, Das A, et al. American Gastroenterological Association (AGA) institute technical review on obscure gastrointestinal bleeding. Gastroenterology. 2007;133:1697–717.CrossRefPubMedGoogle Scholar
  5. 5.
    Yano T, Yamamoto H, Sunada K, et al. Endoscopic classification of vascular lesions of the small intestine (with videos). Gastrointest Endosc. 2008;67:169–72.CrossRefPubMedGoogle Scholar
  6. 6.
    Ohmiya N, Nakamura M, Takenaka H, et al. Management of small-bowel polyps in Peutz-Jeghers syndrome by using enteroclysis, double-balloon enteroscopy, and videocapsule endoscopy. Gastrointest Endosc. 2010;72:1209–16.CrossRefPubMedGoogle Scholar
  7. 7.
    Fukumoto A, Tanaka S, Yamamoto H, et al. Diagnosis and treatment of small-bowel stricture by double-balloon endoscopy. Gastrointest Endosc. 2007;66:S108–12.CrossRefPubMedGoogle Scholar
  8. 8.
    Ohmiya N, Arakawa D, Nakamura M, et al. Small-bowel obstruction: diagnostic comparison between double-balloon endoscopy and fluoroscopic enteroclysis, and the outcome of enteroscopic treatment. Gastrointest Endosc. 2009;69:84–93.CrossRefPubMedGoogle Scholar
  9. 9.
    Despott EJ, et al. Effective dilation of small-bowel strictures by double-balloon enteroscopy in patients with symptomatic Crohn’s disease (with video). Gastrointest Endosc. 2009;70:1030–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Hirai F, Beppu T, Sou S, et al. Endoscopic balloon dilatation using double-balloon endoscopy is a useful and safe treatment for small intestinal strictures in Crohn’s disease. Dig Endosc. 2010;22:200–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Hirai F, Beppu T, Takatsu N, et al. Long-term outcome of endoscopic balloon dilation for small bowel strictures in patients with Crohn’s disease. Dig Endosc. 2014;26:545–51.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2018

Authors and Affiliations

  1. 1.Department of GastroenterologyFukuoka University Chikushi HospitalFukuokaJapan

Personalised recommendations