scholarly journals Development of significant disease in a cohort of patients with non-specific enteritis on capsule endoscopy. Clinical suspicion and a high base line Lewis score are predictive of Crohn’s disease.

2020 ◽  
Author(s):  
Sandeep Sihag ◽  
Brandon Tan ◽  
Serhiy Semenov ◽  
Mohd Syafiq Ismail ◽  
Barbara Ryan ◽  
...  

Abstract Background: As with isolated ileitis the findings of nonspecific small bowel enteritis (NSE) on capsule endoscopy (CE) poses a clinical challenge. There is lack of available evidence to help clinicians to predict significant disease and long-term prognosis. Methods: We aimed to define the natural history of NSE in an Irish cohort. Patients with a finding of NSE were identified from a database. Subsequent investigations, treatments and diagnosis were recorded. Patients were grouped based on ultimate diagnosis: Crohn’s disease (CD), Irritable bowel syndrome (IBS), NSAIDs enteritis (NSAIDs), persistent NSE and no significant disease (NAD). Results: 88 patients, 46 (52%) male, mean age 52 +- 17.8 years were included with a mean follow up of 23 +- 19 months. The ultimate diagnoses were NAD=43 (49%), CD =17 (19%), IBS =14 (16%), NSAIDs =12 (14%) and persistent NSE=2 (2%). Significantly, more patients diagnosed with CD on follow up were referred with suspected CD. CD= 14/17 (82%) vs 13/57 (23%), p < 0.001. While a diagnosis of CD was associated with a positive baseline Lewis score (>135); 11/17 (65%) CD versus 16/ 71 (23%). Female gender was associated with an ultimate diagnosis of IBS (OR 5, p <0.02). Older age was associated with NSAIDs enteritis, while more subjects without significant gastrointestinal disease were anemic on presentation. Conclusion: The majority (49%) of NSE patients do not develop significant small bowel disease. CD occurred in 19% of NSE patients on follow up. Clinical suspicion and capsule severity are predictive of Crohn’s disease on initial CE.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sandeep Sihag ◽  
Brandon Tan ◽  
Serhiy Semenov ◽  
Mohd Syafiq Ismail ◽  
Barbara Ryan ◽  
...  

Abstract Background As with isolated ileitis the findings of nonspecific small bowel enteritis (NSE) on capsule endoscopy (CE) poses a clinical challenge. There is lack of available evidence to help clinicians to predict significant disease and long-term prognosis. Aim To define the natural history of NSE in an Irish cohort. Methods Patients with a finding of NSE were identified from a database. Subsequent investigations, treatments and diagnosis were recorded. Patients were grouped based on ultimate diagnosis: Crohn’s disease (CD), Irritable bowel syndrome (IBS), NSAIDs enteritis (NSAIDs), persistent NSE and no significant disease (NAD). Results 88 patients, 46 (52%) male, mean age 52 ± 17.8 years were included with a mean follow up of 23 ± months. The ultimate diagnoses were NAD = 43 (49%), CD = 17 (19%), IBS = 14 (16%), NSAIDs = 12 (14%) and persistent NSE = 2 (2%). Significantly, more patients diagnosed with CD on follow up were referred with suspected CD. CD = 14/17 (82%) vs 13/57 (23%), p < 0.001. While a diagnosis of CD was associated with a positive baseline Lewis score (> 135); 11/17 (65%) CD versus 16/ 71 (23%). Female gender was associated with an ultimate diagnosis of IBS (OR 5, p < 0.02). Older age was associated with NSAIDs enteritis, while more subjects without significant gastrointestinal disease were anemic on presentation. Conclusion The majority (49%) of NSE patients do not develop significant small bowel disease. CD occurred in 19% of NSE patients on follow up. Clinical suspicion and capsule severity are predictive of Crohn’s disease on initial CE.


2020 ◽  
Author(s):  
Sandeep Sihag ◽  
Brandon Tan ◽  
Serhiy Semenov ◽  
Mohd Syafiq Ismail ◽  
Barbara Ryan ◽  
...  

Abstract Background: As with isolated ileitis the findings of nonspecific small bowel enteritis (NSE) on capsule endoscopy (CE) poses a clinical challenge. There is lack of available evidence to help clinicians to predict significant disease and long-term prognosis.Methods: We aimed to define the natural history of NSE in an Irish cohort. Patients with a finding of NSE were identified from a database. Subsequent investigations, treatments and diagnosis were recorded. Patients were grouped based on ultimate diagnosis: Crohn’s disease (CD), Irritable bowel syndrome (IBS), NSAIDs enteritis (NSAIDs), persistent NSE and no significant disease (NAD).Results: 88 patients, 46 (52%) male, mean age 52 +- 17.8 years were included with a mean follow up of 23 +- 19 months. The ultimate diagnoses were NAD=43 (49%), CD =17 (19%), IBS =14 (16%), NSAIDs =12 (14%) and persistent NSE=2 (2%). Significantly, more patients diagnosed with CD on follow up were referred with suspected CD. CD= 14/17 (82%) vs 13/57 (23%), p < 0.001. While a diagnosis of CD was associated with a positive baseline Lewis score (>135); 11/17 (65%) CD versus 16/ 71 (23%). Female gender was associated with an ultimate diagnosis of IBS (OR 5, p <0.02). Older age was associated with NSAIDs enteritis, while more subjects without significant gastrointestinal disease were anemic on presentation.Conclusion: The majority (49%) of NSE patients do not develop significant small bowel disease. CD occurred in 19% of NSE patients on follow up. Clinical suspicion and capsule severity are predictive of Crohn’s disease on initial CE.


2020 ◽  
Author(s):  
Sandeep Sihag ◽  
Brandon Tan ◽  
Serhiy Semenov ◽  
Mohd Syafiq Ismail ◽  
Barbara Ryan ◽  
...  

Abstract Introduction: As with isolated ileitis the findings of nonspecific small bowel enteritis (NSE) on capsule endoscopy (CE) poses a clinical challenge. There is lack of available evidence to help clinicians to predict significant disease and long-term prognosis.Aim: To define the natural history of NSE in an Irish cohort. Methods: Patients with a finding of NSE were identified from a database. Subsequent investigations, treatments and diagnosis were recorded. Patients were grouped based on ultimate diagnosis: Crohn’s disease (CD), Irritable bowel syndrome (IBS), NSAIDs enteritis (NSAIDs), persistent NSE and no significant disease (NAD).Results: 88 patients, 46 (52%) male, mean age 52 +- 17.8 years were included with a mean follow up of 23 +- 19 months. The ultimate diagnoses were NAD=43 (49%), CD =17 (19%), IBS =14 (16%), NSAIDs =12 (14%) and persistent NSE=2 (2%). Significantly, more patients diagnosed with CD on follow up were referred with suspected CD. CD= 14/17 (82%) vs 13/57 (23%), p < 0.001. While a diagnosis of CD was associated with a positive baseline Lewis score (>135); 11/17 (65%) CD versus 16/ 71 (23%). Female gender was associated with an ultimate diagnosis of IBS (OR 5, p <0.02). Older age was associated with NSAIDs enteritis, while more subjects without significant gastrointestinal disease were anemic on presentation.Conclusion: The majority (49%) of NSE patients do not develop significant small bowel disease. CD occurred in 19% of NSE patients on follow up. Clinical suspicion and capsule severity are predictive of Crohn’s disease on initial CE.


2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Carlo Calabrese ◽  
Margherita Diegoli ◽  
Nikolas Dussias ◽  
Marco Salice ◽  
Fernando Rizzello ◽  
...  

Abstract Background Crohn’s disease (CD) can be classified according to endoscopic and cross-sectional imaging characteristics. Information regarding disease extent and phenotype may be provided by advanced endoscopic and imaging techniques. In this study, we compare the ability of capsule endoscopy (CE) and cross-sectional imaging techniques (CST) (MRE/Computer Tomography Enteroscopy [CTE]) in detecting small bowel (SB) lesions. Methods We retrospectively analyzed 102 patients with a diagnosis of CD who underwent both CE and CST. Only patients with at least a 12-month follow-up after CE were included. Results Sensitivity and specificity for the detection of SB lesions were, respectively, 100% and 83.3% for CE, 55.1% and 80% for CTE, and 60% and 82.3% for MRE. CE detected proximal CD lesions in 73% of patients, whereas MRE and CTE detected proximal lesions in 41% and 16% of patients, respectively (P &lt; 0.001). Positive findings on CE led to management changes in all patients, in a median follow-up period of 58.7 months. During the follow-up period, 26.5% of patients underwent surgery. Multivariate analysis revealed that moderate-to-severe disease at CE was independently correlated with surgery (P = 0.03). Conclusions CE has a superior sensitivity for detecting CD lesions in the proximal and medium SB compared with CST. In the terminal ileum, MRE and CTE displayed similar performance to CE.


2014 ◽  
Vol 8 (12) ◽  
pp. 1616-1623 ◽  
Author(s):  
Eva Niv ◽  
Sigal Fishman ◽  
Helena Kachman ◽  
Ruth Arnon ◽  
Iris Dotan

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