Strictures occur in an estimated 15% to 30% of patients with Crohn’s disease within the first 10 years of diagnosis, according to findings published in BMC Gastroenterology. Several methods have been developed for evaluating small bowel strictures, including CT enterography (CTE) and doubleballoon enteroscopy (DBE). CTE is very effective at detecting small bowel disease, with a sensitivity of 83% and a specificity of 88%. Meanwhile, DBE has the benefit of allowing direct visualization while obtaining biopsies for histopathologic analysis. However, the relationship between symptom severity and the strictures detected through DBE is unknown.
Therefore, this prospective cohort study aimed to determine the detection rate with DBE for patients with CD and small-bowel symptomatic strictures. The study participants were enrolled from a single center in China. All received both CTE and DBE within one month of each other. The symptom severity was assessed through the Crohn’s Disease Obstructive Score (CDOS), with patients divided into low severity (scores 1-3) and high severity (scores 4-6).
The study included 165 patients with CD, 42.4% of whom had low severity symptoms. The researchers reported detection rates of 92.7% with DBE and 85.5% with CTE. For DBE, the rates were 91.4% and 94.7% in the low severity and high severity groups, respectively. For CTE, the detection rate was greater in the high severity versus the low severity group (90.1% and 75.9%, respectively; P=0.01).
“DBE has been demonstrated to be an efficient diagnostic method for detecting small bowel strictures in [patients with CD,” the researchers wrote.
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