Monitoring of small bowel Crohn's disease.

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.

• Authors: Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
• Journal: Expert review of gastroenterology & hepatology (Expert Rev Gastroenterol Hepatol) Vol. 11 Issue 11 Pg. 1047-1058 (Nov 2017) ISSN: 1747-4132 [Electronic] England
• PMID: 28737951 (Publication Type: Journal Article, Review)

Topics

• Capsule Endoscopy
• Crohn Disease (diagnosis, therapy)
• Disease Progression
• Humans
• Magnetic Resonance Imaging
• Predictive Value of Tests
• Remission Induction
• Treatment Outcome
• Ultrasonography