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Review
. 2022 May 1;38(3):292-298.
doi: 10.1097/MOG.0000000000000830. Epub 2022 Feb 25.

Small bowel Crohn's disease: optimal modality for diagnosis and monitoring

Cristina Carretero  1
Affiliations
Review

Small bowel Crohn's disease: optimal modality for diagnosis and monitoring

Cristina Carretero. Curr Opin Gastroenterol. .

Abstract

Purpose of review: This paper reviews different imaging options for small bowel (SB) Crohn's disease (CD) patients.

Recent findings: In total, 80% of patients suffering from CD have SB involvement, being the exclusive manifestation in 30% of cases. As the proximal disease is related to poor response to treatment, a higher rate of stenosis and a greater need for surgical treatment, a SB assessment should be performed. This evaluation should be done not only once the disease has been diagnosed but periodically. The former to determine the extent of the disease, and the latter according to a treat-to-target strategy. Available techniques such as magnetic resonance imaging, intestinal ultrasound and capsule endoscopy (CE) have shown good accuracy parameters in CD patients. Cross-sectional studies are superior for penetrating and stricturing disease, whereas CE is excellent for proximal involvement and mucosal healing. Local expertise and availability may lead the election between techniques, nevertheless, they should not be considered as competitors but as complementary tools.

Summary: SB involvement in CD patients is frequent and related to poorer outcomes. Hence, SB evaluation should be screened after diagnosis and routinely during the follow-up.

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References

    1. Sturm A, Maaser C, Calabrese E, et al. ECCO-esgar guideline for diagnostic assessment in IBD part 2: IBD scores and general principles and technical aspects. J Crohn's Colitis 2019; 13:273–284E.
    1. Hansel SL, Mccurdy JD, Barlow JM, et al. Clinical benefit of capsule endoscopy in Crohn's disease: impact on patient management and prevalence of proximal small bowel involvement. Inflamm Bowel Dis 2018; 24:1582–1588.
    1. Torres J, Mehandru S, Colombel JF, et al. Crohn's disease. Lancet 2017; 389:1741–1755.
    1. Sainz E, Zabana Y, Miguel I, et al. Clinical features, therapeutic requirements and evolution of patients with Crohn's disease and upper gastrointestinal involvement (CROHNEX study). Aliment Pharmacol Ther 2021; 54:1041–1051.
    1. Bruining DH, Siddiki HA, Fletcher JG, et al. Benefit of computed tomography enterography in Crohn's disease: effects on patient management and physician level of confidence. Inflamm Bowel Dis 2012; 18:219–225.

MeSH terms