The use of single balloon enteroscopy in Crohn’s disease and its impact on clinical outcome

Abstract

Objectives: Single balloon enteroscopy (SBE) is an effective and safe modality for the diagnosis and therapeutic intervention of small bowel disorders. Its use in patients with Crohn’s disease (CD) and particularly its effect on management changes in CD have not yet been determined.

Materials and methods: We performed a retrospective review of the endoscopic and clinical data available on a cohort of patients with small bowel CD who had undergone SBE to determine the diagnostic and therapeutic yield of the procedure and the initial and longer-term impact it had on clinical management.

Results: About 52 patients have undergone SBE in our unit for the investigation of known (n = 39) or suspected (n = 13) small bowel CD with a diagnostic yield of 77% and 39%, respectively. SBE had an immediate clinical impact in 69% (n = 33) of patients, including dilatation of a stricture in 27% (n = 13), initiation or adjustment of dose of medications in 48% (n = 23), referral for surgical resection in 6% (n = 3). Moreover, the procedure permitted determining a new diagnosis of CD in 8% of the patients (n = 4), and excluding it in 8% (n = 4). Longer term follow-up was available in 34 patients (65%) which showed a significant difference in mean HBI score from 6.6 before the procedure to 4.2 after it (p < .0001).

Conclusions: SBE has a high diagnostic and therapeutic yield in CD and significantly impacts disease management. Careful patient selection is a key factor in optimizing its use in CD.

Keywords:

• Crohn’s disease
• single balloon enteroscopy
• stricture dilatation
• small bowel disorder
• approach of care

Disclosure statement

Guido Costamagna has received grant/research support from Olympus Japan, is a member of advisory committees or review panels for Cook, Inc., Boston Scientific Corp., and Taewoong Medical, Inc., and has been a speaker and teacher for Boston Scientific, Corp. and Given Imaging. Other authors declare no Conflict of Interests for this article.