Monitoring of small bowel Crohn’s disease

Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: In recent years, the therapeutic paradigm in Crohn’s disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such ‘treat-to-target’ approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn’s disease, the small bowel is affected in the majority of patients; frequently, Crohn’s involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques. Thus, non-invasive monitoring techniques are crucial for accurate disease assessment. Areas covered: This review addresses the indications and clinical implications of non-invasive small bowel monitoring modalities (magnetic resonance enterography, intestinal ultrasound, capsule endoscopy) in the assessment and management of Crohn’s disease. Expert commentary: This review addresses the limitations of the current knowledge and future areas of research, including the possible utilization of transmural healing as an imaging target and the need to establish clear quantitative target values to guide treatment by imaging findings in Crohn’s disease.

Original languageEnglish
Pages (from-to)1047-1058
Number of pages12
JournalExpert Review of Gastroenterology and Hepatology
Volume11
Issue number11
DOIs
StatePublished - 2 Nov 2017

Keywords

  • Crohn’s disease
  • capsule endoscopy
  • fecal calprotectin
  • intestinal ultrasound
  • magnetic resonance enterography
  • mucosa healing
  • transmural healing

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