Abstract
Background
Crohn’s disease is associated with accumulation of progressive structural bowel damage
(SBD) leading to the development of stenotic and penetrating complications. The data
pertaining to the course of progression of SBD is scarce. The Lemann index (LI) is
a novel tool for evaluation of SBD that incorporates pan-enteric clinical, endoscopic
and imaging data.
Aims
To evaluate the progression of SBD in quiescent CD patients.
Methods
Patients with known quiescent small bowel Crohn’s disease (CD) for at least 3 months
(CDAI < 220) were prospectively recruited and underwent repeated magnetic resonance enterographies
(MRE) and video capsule endoscopies (VCE). Patients were assessed for SBD on initial
and follow-up evaluation using relevant clinicopathological data, MRE and VCE results.
Significant structural bowel damage (SBD) was identified as LI > 4.8, and progression of SBD as LI > 0.3.
Results
Sixty one patients were enrolled in the study. Significant SBD was detected 13 (21.4%)
on enrollment. Duration of disease (p = 0.036) and history of CD-related surgery (p = 0.0001) were associated with significant BD. Forty one patients underwent a follow-up
MRE (14.8 ± 2.5 months apart). LI was similar at baseline and follow-up. There was a negligible
change in LI between the evaluations.
Conclusions
In patients with quiescent Crohn’s disease, structural bowel damage was stable over
a median of 14 months follow-up.
Keywords
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Article info
Publication history
Published online: February 12, 2017
Accepted:
February 1,
2017
Received in revised form:
January 31,
2017
Received:
December 3,
2016
Footnotes
☆The study was partially supported by a generous grant from the Leona M. and Harry B. Helmsley Charitable Trust.
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
