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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583773/ https://www.ncbi.nlm.nih.gov/pubmed/34751600 http://dx.doi.org/10.1080/07853890.2021.1998597 |
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author | Hayashi, Yukie Takabayashi, Kaoru Hosoe, Naoki Kiyohara, Hiroki Kinoshita, Satoshi Nanki, Kosaku Fukuhara, Kayoko Mikami, Yohei Sujino, Tomohisa Mutaguchi, Makoto Kawaguchi, Takaaki Kato, Motohiko Ogata, Haruhiko Kanai, Takanori |
author_facet | Hayashi, Yukie Takabayashi, Kaoru Hosoe, Naoki Kiyohara, Hiroki Kinoshita, Satoshi Nanki, Kosaku Fukuhara, Kayoko Mikami, Yohei Sujino, Tomohisa Mutaguchi, Makoto Kawaguchi, Takaaki Kato, Motohiko Ogata, Haruhiko Kanai, Takanori |
author_sort | Hayashi, Yukie |
collection | PubMed |
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 MESSAGES: When 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 | Online Article Text |
id | pubmed-8583773 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-85837732021-11-12 Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis Hayashi, Yukie Takabayashi, Kaoru Hosoe, Naoki Kiyohara, Hiroki Kinoshita, Satoshi Nanki, Kosaku Fukuhara, Kayoko Mikami, Yohei Sujino, Tomohisa Mutaguchi, Makoto Kawaguchi, Takaaki Kato, Motohiko Ogata, Haruhiko Kanai, Takanori Ann Med Gastroenterology & Hepatology 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 MESSAGES: When 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. Taylor & Francis 2021-11-09 /pmc/articles/PMC8583773/ /pubmed/34751600 http://dx.doi.org/10.1080/07853890.2021.1998597 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Gastroenterology & Hepatology Hayashi, Yukie Takabayashi, Kaoru Hosoe, Naoki Kiyohara, Hiroki Kinoshita, Satoshi Nanki, Kosaku Fukuhara, Kayoko Mikami, Yohei Sujino, Tomohisa Mutaguchi, Makoto Kawaguchi, Takaaki Kato, Motohiko Ogata, Haruhiko Kanai, Takanori Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis |
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 | Gastroenterology & Hepatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583773/ https://www.ncbi.nlm.nih.gov/pubmed/34751600 http://dx.doi.org/10.1080/07853890.2021.1998597 |
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