Significance of endoscopic deep small bowel evaluation using balloon-assisted enteroscopy for Crohn’s disease in clinical remission

Kaoru Takabayashi, Naoki Hosoe, Motohiko Kato, Yukie Hayashi, Kosaku Nanki, Kayoko Fukuhara, Yohei Mikami, Shinta Mizuno, Tomohisa Sujino, Makoto Mutaguchi, Makoto Naganuma, Naohisa Yahagi, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Background: Small bowel lesions of Crohn’s disease (CD) are known to be associated with a poor prognosis; however, endoscopic healing leads to favorable patients’ outcome. The aim of this study was to clarify the clinical impact of assessing deep small bowel lesions (DSB) using balloon-assisted enteroscopy (BAE) on CD patients in clinical remission. Methods: From January 2012 to July 2018, a total of 100 CD patients in clinical remission were enrolled to undergo trans-anal enteroscopy using single-balloon enteroscope. Endoscopic evaluations at the terminal ileum (TI) were performed using a partial Simple Endoscopic Score for CD (pSES-CD). Endoscopic evaluations at the DSB used a modified partial SES-CD (mpSES-CD). We evaluated the factors associated with relapse, and the correlation of endoscopic score between the TI and DSB. For this study, relapse was defined as hospitalization within a year from enteroscopy. Results: 30 patients (30.0%) relapsed within a year from enteroscopy. Multivariate logistic regression analysis revealed that the Harvey–Bradshaw Index (OR 1.77, 95% CI 1.18–2.65; p = 0.003) and an mpSES-CD at DSB (OR 3.10, 95% CI 1.86–5.15; p = 0.001) were independent predictors for relapse, whereas a SES-CD at the TI did not exhibit independence. There was a significant correlation trend between the relapse rate and greater than 5 points of an mpSES-CD at DSB; however, there was no correlation between the relapse rate and pSES-CD at the TI. Conclusion: Even when Crohn's disease is in remission, it is important to evaluate DSB using BAE to assess endoscopic mucosal healing.

Original languageEnglish
Pages (from-to)25-33
Number of pages9
JournalJournal of gastroenterology
Issue number1
Publication statusPublished - 2021 Jan


  • Balloon-assisted enteroscopy
  • Enteroscopy
  • Simple endoscopic score for Crohn’s disease

ASJC Scopus subject areas

  • Gastroenterology


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