Enteroscopy in small bowel Crohn's disease: A review

Area of Science:

• Gastroenterology
• Endoscopy
• Inflammatory Bowel Disease

Background:

• Crohn's disease (CD) is a chronic gastrointestinal inflammatory condition.
• Small bowel CD management is challenging due to limited accessibility.
• Enteroscopy has advanced, improving diagnosis and therapy for small bowel diseases.

Purpose of the Study:

• To review the role of enteroscopy in diagnosing and managing small bowel Crohn's disease.
• To compare the efficacy and limitations of different device-assisted enteroscopy (DAE) modalities.

Main Methods:

• Review of current evidence on enteroscopy for small bowel CD.
• Focus on device-assisted enteroscopy (DAE) including balloon-assisted enteroscopy (BAE): double balloon enteroscopy (DBE), single balloon enteroscopy (SBE), and spiral enteroscopy (SE).

Main Results:

• DAE modalities demonstrate comparable insertion depths, diagnostic and therapeutic efficacies, and complication rates.
• Double balloon enteroscopy (DBE) is often favored for higher total enteroscopy rates.
• Spiral enteroscopy (SE) offers quicker procedures but potentially lower complete enteroscopy rates; single balloon enteroscopy (SBE) is evolving.

Conclusions:

• Device-assisted enteroscopy (DAE) is crucial for small bowel Crohn's disease management.
• Current evidence suggests comparable efficacy among DBE, SBE, and SE, with variations in procedural efficiency and completeness.
• Further randomized controlled trials are needed to clarify optimal enteroscopy use in small bowel CD.