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IBD
Effectiveness of transabdominal ultrasonography in predicting clinical relapse of Crohn’s disease
Shinya Fukushima, Takehiko Katsurada, Mutsumi Nishida, Satomi Omotehara, Kensuke Sakurai, Kana Yamanashi, Reizo Onishi, Naoya Sakamoto
Intest Res 2024;22(1):82-91.   Published online January 29, 2024
DOI: https://doi.org/10.5217/ir.2023.00093
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Transabdominal ultrasonography (US) helps evaluate Crohn’s disease (CD) activity. We investigated whether the US could predict subsequent adverse outcomes for patients with CD in clinical remission.
Methods
This single-center retrospective study included patients with CD in clinical remission who underwent US between April 2011 and April 2021, focusing on the predictability of subsequent adverse outcomes within 5 years. We used the US-CD, which was calculated using multiple US findings. Predictive variables were assessed using Cox proportional hazards regression analysis, and the predictive value was evaluated using receiver operating characteristic curves.
Results
Seventy-three patients were included. During a median follow-up of 1,441 days (range, 41–1,825 days), 16.4% (12/73) experienced clinical relapse, 9.6% (7/73) required endoscopic balloon dilation (EBD), 58.9% (43/73) required enhanced treatment, and 20.5% (15/73) underwent surgery. In the multivariate analysis, US-CD was significantly associated with clinical relapse (P= 0.038) and the need for enhanced treatment (P= 0.005). The area under the receiver operating characteristic curve for predicting clinical relapse and the need for EBD was 0.77 and 0.81, respectively, with US-CD (cutoff value = 11), and that for requiring enhanced treatment was 0.74 with US-CD (cutoff value = 6). Patients with US-CD ≥ 11 demonstrated a significantly higher occurrence of clinical relapse (P= 0.001) and EBD (P= 0.002) within 5 years. Patients with US-CD ≥ 6 experienced a significantly higher likelihood of requiring enhanced treatment (P< 0.001) within 5 years.
Conclusions
High US-CD is associated with subsequent adverse outcomes in patients with CD.

Citations

Citations to this article as recorded by  
  • Non-invasive monitoring of inflammatory bowel disease using intestinal ultrasound
    Hakima Abid, Hajar Cherkaoui, Fatima Benahsine, Asmae Lamine, Maria Lahlali, Ismail Chaouche, Fatima Bartal, Nada Lahmidani, Amine Elmekkaoui, Dafr Allah Benajah, Mohammed Abkari, Sidi Adil Ibrahimi, Karima Elghazi, Mustapha Maaroufi, Mounia Elyousfi
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • 2,939 View
  • 143 Download
  • 1 Web of Science
  • 1 Crossref
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Endoscopy
Prototype single-balloon enteroscopy with passive bending and high force transmission improves depth of insertion in the small intestine
Yasuhiro Morita, Shigeki Bamba, Osamu Inatomi, Kenichiro Takahashi, Takayuki Imai, Masaki Murata, Masashi Ohno, Masaya Sasaki, Tomoyuki Tsujikawa, Akira Andoh
Intest Res 2020;18(2):229-237.   Published online April 9, 2020
DOI: https://doi.org/10.5217/ir.2019.09150
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We retrospectively analyzed Crohn’s disease (CD) patients with small intestinal strictures who underwent single-balloon enteroscopy (SBE) to ascertain whether prototype SBEs with a passive bending mechanism and high force transmission insertion tube had better insertability in the small intestine than a conventional SBE.
Methods
Among 253 CD patients who underwent SBE, we identified 94 CD patients who had undergone attempted endoscopic balloon dilatation (EBD) for small intestinal stenosis for inclusion in this study. We analyzed whether the type of scope used for their initial procedure affected the cumulative surgery-free rate. For the insertability analysis, patients who underwent SBE at least twice were divided into 3 groups according to the type of scope used: conventional SBE only, prototype SBE only, and both conventional and prototype SBEs. For each group, depth of insertion, procedure time, and number of EBDs were compared in the same patient at different time points.
Results
The success rate of EBD was 88.3%. The 5- and 10-year cumulative surgery-free rate was 75.7% and 72.8%, respectively. Cox regression analysis indicated that the factors contributing to surgery were long stricture (≥2 cm), EBD failure, and elevated Crohn’s Disease Activity Index, but not the type of scope used for EBD. The prototype SBEs significantly improved the depth of insertion (P=0.03, Wilcoxon’s signed-rank test).
Conclusions
In CD patients with small intestinal stenosis, the prototype SBEs with a passive bending mechanism and high force transmission insertion tube did not improve long-term EBD outcome but did improve deep insertability. (Clinical Trial Registration No. UMIN000037102)

Citations

Citations to this article as recorded by  
  • Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
    Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • Role of Device-Assisted Enteroscopy in Crohn’s Disease
    Giulia Catassi, Clelia Marmo, Antonio Gasbarrini, Maria Elena Riccioni
    Journal of Clinical Medicine.2024; 13(13): 3919.     CrossRef
  • Performance of Balloon-Assisted Enteroscopy for Non-ERCP Indications in Patients with Surgically Altered Gastrointestinal Anatomy
    Ji Hee Song, Seong Ran Jeon, Jin Su Kim, Bo-In Lee, Jin-Oh Kim, Han Hee Lee
    Digestive Diseases and Sciences.2023; 68(6): 2545.     CrossRef
  • Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
    Yuna Kim, Jae-Hyun Kim, Eun-Ae Kang, Soo-Jung Park, Jae-Jun Park, Jae-Hee Cheon, Tae-Il Kim, Jihye Park, Seong-Ran Jeon
    Diagnostics.2022; 12(4): 954.     CrossRef
  • Intestinal stricture in Crohn's disease: A 2020 update
    Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
    Journal of Digestive Diseases.2021; 22(7): 390.     CrossRef
  • Factors Affecting Route Selection of Balloon-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
    Dong Hoon Baek, Seonyeong Hwang, Chang Soo Eun, Seong Ran Jeon, Jinsu Kim, Eun Ran Kim, Dong-Hoon Yang, Hyun Joo Jang, Jong Pil Im, Soo Jung Park, Sung Hoon Jung
    Diagnostics.2021; 11(10): 1860.     CrossRef
  • 7,203 View
  • 114 Download
  • 6 Web of Science
  • 6 Crossref
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Review
Current status of endoscopic balloon dilation for Crohn's disease
Fumihito Hirai
Intest Res 2017;15(2):166-173.   Published online April 27, 2017
DOI: https://doi.org/10.5217/ir.2017.15.2.166
AbstractAbstract PDFPubReaderePub

The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.

Citations

Citations to this article as recorded by  
  • Safety and effectiveness of additional triamcinolone acetonide with endoscopic radial incision and cutting for benign stenosis of the lower gastrointestinal tract: A pilot study
    Rintaro Moroi, Kotaro Nochioka, Satoshi Miyata, Hideya Iwaki, Hirofumi Chiba, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Masaki Tosa, Yoichi Kakuta, Shoichi Kayaba, Seiichi Takahashi, Yoshitaka Kinouchi, Atsushi Masamune
    DEN Open.2025;[Epub]     CrossRef
  • Endoscopic radial incision and cutting using balloonassisted enteroscopy for small intestinal stenosis related to Crohn’s disease: a pilot study
    Rintaro Moroi, Kotaro Nochioka, Satoshi Miyata, Hideya Iwaki, Hirofumi Chiba, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Masaki Tosa, Yoichi Kakuta, Shoichi Kayaba, Seiichi Takahashi, Yoshitaka Kinouchi, Atsushi Masamune
    Intestinal Research.2025;[Epub]     CrossRef
  • Enteroscopic Balloon Dilation in Small Bowel Stricturing Crohn’s Disease: Long‐Term Outcomes and Risk Factors for Surgery in a Single‐Center Prospective Observational Study
    Sung Noh Hong, Ji Eun Kim, Eun Ran Kim, Dong Kyung Chang, Young‐Ho Kim
    United European Gastroenterology Journal.2025;[Epub]     CrossRef
  • Prediction of endoscopic restenosis after endoscopic balloon dilation in patients with Crohn’s disease: a machine learning approach
    Tao Su, Yi Lu, Nan Lan, Hongzhen Wu, Luying Wu, Min Zhang, Xiaoling Wang, Jiachen Sun, Jiayin Yao, Min Zhi
    Surgical Endoscopy.2025; 39(6): 3896.     CrossRef
  • Short-term outcomes of bariatric surgery in patients with inflammatory bowel disease: a national analysis
    Russyan Mark Mabeza, Amulya Vadlakonda, Nikhil Chervu, Shayan Ebrahimian, Sara Sakowitz, Amy Yetasook, Peyman Benharash
    Surgery for Obesity and Related Diseases.2024; 20(2): 146.     CrossRef
  • Efficacy and Safety of Endoscopic Stricturotomy in Inflammatory Bowel Disease-Related Strictures: A Systematic Review and Meta-Analysis
    Fouad Jaber, Laith Numan, Mohammed Ayyad, Mohamed Abuelazm, Muhammad Imran, Majd M. AlBarakat, Aya M. Aboutaleb, Ubaid Khan, Saqr Alsakarneh, Mohammad Bilal
    Digestive Diseases and Sciences.2024; 69(11): 4152.     CrossRef
  • Advanced Techniques in Therapeutic and Inflammatory Bowel Disease Colonoscopy
    Alexander Worix, Rajesh N. Keswani
    Gastroenterology Clinics of North America.2024; 53(4): 587.     CrossRef
  • Clinical Practice and Safety of Endoscopic Balloon Dilation for Crohn’s Disease–Related Strictures: A Nationwide Claim Database Analysis in Japan
    Rintaro Moroi, Kunio Tarasawa, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Shin Hamada, Yoichi Kakuta, Kiyohide Fushimi, Kenji Fujimori, Yoshitaka Kinouchi, Atsushi Masamune, Eiji Sakai
    Gastroenterology Research and Practice.2024;[Epub]     CrossRef
  • Endoskopische und chirurgische Behandlung intestinaler Stenosen im Zusammenhang mit chronisch-entzündlichen Darmerkrankungen
    Tabea Pfister, Jonas Zbinden, Benjamin Misselwitz, Emanuel Burri, Florian Rieder, Lukas Brügger, Reiner Wiest
    Schweizer Gastroenterologie.2024; 5(4): 103.     CrossRef
  • Factors associated with the efficacy and safety of endoscopic dilatation of symptomatic strictures in Crohn’s disease: a retrospective cohort study
    Pierre Dandoy, Edouard Louis, Pierrette Gast, Maxime Poncin, Laurence Seidel, Jean-Philippe Loly
    Scandinavian Journal of Gastroenterology.2023; 58(6): 671.     CrossRef
  • Approach to Endoscopic Balloon Dilatation in Pediatric Stricturing Crohn Disease: A Position Paper of the Endoscopy Special Interest Group of ESPGHAN
    Oren Ledder, Matjaž Homan, Raoul Furlano, Alexandra Papadopoulou, Salvatore Oliva, Jorge Amil Dias, Luigi Dall’oglio, Simona Faraci, Priya Narula, Dominique Schluckebier, Bruno Hauser, Andreia Nita, Claudio Romano, Christos Tzivinikos, Patrick Bontems, Mi
    Journal of Pediatric Gastroenterology & Nutrition.2023; 76(6): 799.     CrossRef
  • Anastomotic Configuration and Temporary Diverting Ileostomy Do Not Increase Risk of Anastomotic Stricture in Postoperative Crohn's Disease
    Salam P. Bachour, Muhammad Z. Khan, Ravi S. Shah, Abel Joseph, Hareem Syed, Adel Hajj Ali, Florian Rieder, Stefan D. Holubar, Edward L. Barnes, Jordan Axelrad, Miguel Regueiro, Benjamin L. Cohen, Benjamin H. Click
    American Journal of Gastroenterology.2023; 118(12): 2212.     CrossRef
  • Novel deformable self-assembled magnetic anastomosis ring for endoscopic treatment of colonic stenosis via natural orifice
    Miao-Miao Zhang, Guang-Bin Zhao, Han-Zhi Zhang, Shu-Qin Xu, Ai-Hua Shi, Jian-Qi Mao, Jing-Ci Gai, Yu-Han Zhang, Jia Ma, Yun Li, Yi Lyu, Xiao-Peng Yan
    World Journal of Gastroenterology.2023; 29(33): 5005.     CrossRef
  • Magnetic compression anastomosis for sigmoid stenosis treatment: A case report
    Miao-Miao Zhang, Yi Gao, Xiao-Yang Ren, Huan-Chen Sha, Yi Lyu, Fang-Fang Dong, Xiao-Peng Yan
    World Journal of Gastrointestinal Endoscopy.2023; 15(12): 745.     CrossRef
  • A Phase II Clinical Trial to Study the Safety of Triamcinolone after Endoscopic Radial Incision and Cutting Dilatation for Benign Stenosis of the Lower Gastrointestinal Tract: A Study Protocol
    RINTARO MOROI, HISASHI SHIGA, KOTARO NOCHIOKA, HIROFUMI CHIBA, YUSUKE SHIMOYAMA, MOTOYUKI ONODERA, TAKEO NAITO, MASAKI TOSA, YOICHI KAKUTA, YUICHIRO SATO, SHOICHI KAYABA, SEICHI TAKAHASHI, SATOSHI MIYATA, YOSHITAKA KINOUCHI, ATSUSHI MASAMUNE
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  • Usefulness of Fluoroscopy for Endoscopic Balloon Dilation of Crohn’s Disease-Related Strictures
    Hyun Seok Lee, Michael V. Chiorean, Elisa Boden, James Lord, Shayan Irani, Richard Kozarek, Michael Larsen, Andrew Ross
    Digestive Diseases and Sciences.2022; 67(4): 1295.     CrossRef
  • Long‐term outcomes of endoscopic balloon dilation for intestinal strictures in patients with Crohn's disease during maintenance treatment with anti‐tumor necrosis factor alpha antibodies
    Teruyuki Takeda, Masahiro Kishi, Noritaka Takatsu, Yasumichi Takada, Tsuyoshi Beppu, Masaki Miyaoka, Takashi Hisabe, Toshiharu Ueki, Hisatomi Arima, Fumihito Hirai, Kenshi Yao
    Digestive Endoscopy.2022; 34(3): 517.     CrossRef
  • A pilot study investigating the safety and feasibility of endoscopic dilation using a radial incision and cutting technique for benign strictures of the small intestine: a study protocol
    Rintaro Moroi, Hisashi Shiga, Kotaro Nochioka, Yusuke Shimoyama, Masatake Kuroha, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
    Pilot and Feasibility Studies.2022;[Epub]     CrossRef
  • Endoscopic radial incision and cutting for benign stenosis of the lower gastrointestinal tract: An investigation of novel endoscopic treatment in multicenter trial
    Rintaro Moroi, Hisashi Shiga, Kotaro Nochioka, Hirofumi Chiba, Yusuke Shimoyama, Masatake Kuroha, Masaki Tosa, Yoichi Kakuta, Shoichi Kayaba, Seiichi Takahashi, Yoshitaka Kinouchi, Atsushi Masamune
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1554.     CrossRef
  • Guidelines for endoscopic balloon dilation in treating Crohn's disease‐associated small intestinal strictures (supplement to the Clinical Practice Guidelines for Enteroscopy)
    Hironori Yamamoto, Tomonori Yano, Akihiro Araki, Motohiro Esaki, Kazuo Ohtsuka, Naoki Ohmiya, Shiro Oka, Hiroshi Nakase, Shigeki Bamba, Fumihito Hirai, Naoki Hosoe, Tomoki Matsuda, Keigo Mitsui, Kenji Watanabe, Haruhiko Ogata, Shinichi Katsuki, Takayuki M
    Digestive Endoscopy.2022; 34(7): 1278.     CrossRef
  • Managing Stricturing Crohn's Disease: Resect? Strictureplasty? Dilate?
    Lea Lowenfeld, Fabrizio Michelassi
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 881.     CrossRef
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    Giuseppe Cicero, Silvio Mazziotti
    Intestinal Research.2021; 19(4): 365.     CrossRef
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    Journal of Gastroenterology.2020; 55(6): 579.     CrossRef
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    Mattia Crespi, Pietro Dulbecco, Antonella De Ceglie, Massimo Conio
    Digestive Diseases and Sciences.2020; 65(7): 1904.     CrossRef
  • A Novel Capsule Endoscopic Score for Crohn’s Disease
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    Crohn's & Colitis 360.2020;[Epub]     CrossRef
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    Shan-Bing Yang, Shu-Wen Du, Ji-Heng Wang
    World Journal of Clinical Cases.2020; 8(13): 2769.     CrossRef
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    Jason Reinglas, Talat Bessissow
    Gastrointestinal Endoscopy Clinics of North America.2019; 29(3): 549.     CrossRef
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    Talat Bessissow, Jason Reinglas, Achuthan Aruljothy, Peter L Lakatos, Gert Van Assche
    World Journal of Gastroenterology.2018; 24(17): 1859.     CrossRef
  • Endoscopic Balloon Dilation for Crohn’s Disease-Associated Strictures
    Thomas Klag, Jan Wehkamp, Martin Goetz
    Clinical Endoscopy.2017; 50(5): 429.     CrossRef
  • Endoscopy in inflammatory bowel disease: advances in disease management
    Elizabeth A. Scoville, David A. Schwartz
    Gastrointestinal Endoscopy.2017; 86(6): 952.     CrossRef
  • 9,604 View
  • 110 Download
  • 30 Web of Science
  • 31 Crossref
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