TY - JOUR
T1 - Monitoring of small bowel Crohn’s disease
AU - Kopylov, Uri
AU - Koulaouzidis, Anastasios
AU - Klang, Eyal
AU - Carter, Dan
AU - Ben-Horin, Shomron
AU - Eliakim, Rami
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2017/11/2
Y1 - 2017/11/2
N2 - 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.
AB - 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.
KW - Crohn’s disease
KW - capsule endoscopy
KW - fecal calprotectin
KW - intestinal ultrasound
KW - magnetic resonance enterography
KW - mucosa healing
KW - transmural healing
UR - http://www.scopus.com/inward/record.url?scp=85031313732&partnerID=8YFLogxK
U2 - 10.1080/17474124.2017.1359541
DO - 10.1080/17474124.2017.1359541
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AN - SCOPUS:85031313732
SN - 1747-4124
VL - 11
SP - 1047
EP - 1058
JO - Expert Review of Gastroenterology and Hepatology
JF - Expert Review of Gastroenterology and Hepatology
IS - 11
ER -