Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis
Background and Aim In patients with Crohn’s disease (CD) and small bowel stenosis, endoscopic balloon dilation (EBD) is considered to be useful in improving stenotic symptoms and avoiding surgery. However, it carries risks such as bleeding and perforation. The aim of this study was to identify the i...
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Taylor & Francis Group
2021-01-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2021.1998597 |
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| author | Yukie Hayashi Kaoru Takabayashi Naoki Hosoe Hiroki Kiyohara Satoshi Kinoshita Kosaku Nanki Kayoko Fukuhara Yohei Mikami Tomohisa Sujino Makoto Mutaguchi Takaaki Kawaguchi Motohiko Kato Haruhiko Ogata Takanori Kanai |
| author_facet | Yukie Hayashi Kaoru Takabayashi Naoki Hosoe Hiroki Kiyohara Satoshi Kinoshita Kosaku Nanki Kayoko Fukuhara Yohei Mikami Tomohisa Sujino Makoto Mutaguchi Takaaki Kawaguchi Motohiko Kato Haruhiko Ogata Takanori Kanai |
| author_sort | Yukie Hayashi |
| collection | DOAJ |
| description | Background and Aim In patients with Crohn’s disease (CD) and small bowel stenosis, endoscopic balloon dilation (EBD) is considered to be useful in improving stenotic symptoms and avoiding surgery. However, it carries risks such as bleeding and perforation. The aim of this study was to identify the indications for endoscopic intervention in patients with CD and small bowel stenosis.Methods From November 2007 to March 2020, 143 CD patients with small bowel stenosis were enrolled in this study. We identified the factors associated with not requiring endoscopic intervention during long-term follow-up of these patients.Results Forty of the 143 patients had abdominal symptoms of stenosis and had undergone EBD, whereas the remaining 103 were asymptomatic and had not undergone endoscopic intervention. During long-term follow-up, 95 of those 103 patients never required endoscopic or surgical intervention. Multivariate logistic regression analysis revealed that not consuming an elemental diet (OR 3.18, 95% CI 1.48–6.82; p < .01) and ileocecal valve (ICV) stenosis (OR 0.30, 95% CI 0.11–0.83; p = .02) were independently associated with not requiring EBD. The cumulative emergency hospitalisation-free rate also tended to be higher in patients not consuming an elemental diet or with ICV stenosis.Conclusions Two factors, namely not consuming an elemental diet and ICV stenosis, predict a long-term intervention-free prognosis in CD patients with small bowel stenosis.Key messagesWhen an endoscopically impassable small bowel stenosis is found in a CD patient, long-term follow-up without endoscopic intervention may be possible if the patient is asymptomatic, is not using an elemental diet, and the stenosis is ICV. |
| format | Article |
| id | doaj-art-5eeccfacb8b74bad8fc71f82c5ad9b1e |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-5eeccfacb8b74bad8fc71f82c5ad9b1e2025-08-20T03:44:01ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602021-01-015312025203310.1080/07853890.2021.1998597Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosisYukie Hayashi0Kaoru Takabayashi1Naoki Hosoe2Hiroki Kiyohara3Satoshi Kinoshita4Kosaku Nanki5Kayoko Fukuhara6Yohei Mikami7Tomohisa Sujino8Makoto Mutaguchi9Takaaki Kawaguchi10Motohiko Kato11Haruhiko Ogata12Takanori Kanai13Division of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanCenter for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, JapanCenter for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanCenter for Preventive Medicine, Keio University Hospital, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanCenter for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanCenter for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, JapanDivision of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, JapanBackground and Aim In patients with Crohn’s disease (CD) and small bowel stenosis, endoscopic balloon dilation (EBD) is considered to be useful in improving stenotic symptoms and avoiding surgery. However, it carries risks such as bleeding and perforation. The aim of this study was to identify the indications for endoscopic intervention in patients with CD and small bowel stenosis.Methods From November 2007 to March 2020, 143 CD patients with small bowel stenosis were enrolled in this study. We identified the factors associated with not requiring endoscopic intervention during long-term follow-up of these patients.Results Forty of the 143 patients had abdominal symptoms of stenosis and had undergone EBD, whereas the remaining 103 were asymptomatic and had not undergone endoscopic intervention. During long-term follow-up, 95 of those 103 patients never required endoscopic or surgical intervention. Multivariate logistic regression analysis revealed that not consuming an elemental diet (OR 3.18, 95% CI 1.48–6.82; p < .01) and ileocecal valve (ICV) stenosis (OR 0.30, 95% CI 0.11–0.83; p = .02) were independently associated with not requiring EBD. The cumulative emergency hospitalisation-free rate also tended to be higher in patients not consuming an elemental diet or with ICV stenosis.Conclusions Two factors, namely not consuming an elemental diet and ICV stenosis, predict a long-term intervention-free prognosis in CD patients with small bowel stenosis.Key messagesWhen an endoscopically impassable small bowel stenosis is found in a CD patient, long-term follow-up without endoscopic intervention may be possible if the patient is asymptomatic, is not using an elemental diet, and the stenosis is ICV.https://www.tandfonline.com/doi/10.1080/07853890.2021.1998597Crohn’s diseasesmall bowel stenosisendoscopic balloon dilatation |
| spellingShingle | Yukie Hayashi Kaoru Takabayashi Naoki Hosoe Hiroki Kiyohara Satoshi Kinoshita Kosaku Nanki Kayoko Fukuhara Yohei Mikami Tomohisa Sujino Makoto Mutaguchi Takaaki Kawaguchi Motohiko Kato Haruhiko Ogata Takanori Kanai Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis Annals of Medicine Crohn’s disease small bowel stenosis endoscopic balloon dilatation |
| title | Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
| title_full | Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
| title_fullStr | Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
| title_full_unstemmed | Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
| title_short | Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
| title_sort | predictors of necessity for endoscopic balloon dilatation in patients with crohn s disease related small bowel stenosis |
| topic | Crohn’s disease small bowel stenosis endoscopic balloon dilatation |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2021.1998597 |
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