Balloon-assisted enteroscopy effective for small-bowel strictures in Crohn's

Last Updated: 2017-12-07

By Reuters Staff

NEW YORK (Reuters Health) - Endoscopic balloon dilation (EBD) with balloon-assisted enteroscopy (BAE) is safe and effective for small-bowel strictures in patients with Crohn's disease (CD), a prospective cohort study shows.

"The results suggest: the technical feasibility is equivalent to that of conventional EBD for the large bowel and for ileocolic anastomoses; short-term symptomatic improvement was seen in 70% of the subjects; and the procedure is safe," Dr. Fumihito Hira of Fukuoka University Chikushi Hospital in Japan and colleagues write in their November 29 online report in the Journal of Crohn's and Colitis.

Most Crohn's patients require surgery, and intestinal strictures are a leading reason for these surgeries, the authors note. Use of EBD in Crohn's has been limited given the difficulty of reaching far into the small intestine, they add, but the development of BAE and double-balloon enteroscopy (DBE) have facilitated diagnosis and treatment of small-bowel disease. Retrospective studies and case series have suggested that EBD with BAE is effective for treating small-bowel strictures.

In the new study, researchers at 23 institutions across Japan prospectively enrolled CD patients with at least one symptom of small-bowel stricture, no perforative complications, stricture length of 5 cm or less, no deep active ulcers, and no tight bends or severe adhesions.

Of 95 patients eligible for the study, 46 (48%) had one stricture; the other 49 (52%) had multiple narrowed sites.

EBD was successful in 89 participants (93.7%). By 4 weeks after EBD, 66 patients (69.5%) showed visual analog score (VAS) improvement in all symptoms. Overall, VAS scores for abdominal pain, abdominal bloating, and nausea decreased significantly at four weeks compared to baseline.

Dr. Hira and colleagues conclude, "This prospective, comparative observational study with a large number of patients demonstrated the efficacy and safety of EBD for small-bowel stricture."

SOURCE: http://bit.ly/2A1mBms

J Crohns Colitis 2017.