Characteristics of Isolated Small Bowel Crohn’s Disease: A Comprehensive Comparison with Small Bowel and Colon Involved Crohn’s Disease

Abstract

Background: Some studies showed that small bowel involved Crohn’s Disease (CD) was more serious, which required early identification and aggressive treatment. However, studies investigating small bowel involved CD, especially isolated small bowel CD with large sample size, are limited. Methods: From November 2013 to August 2018, consecutive patients who were confirmed to have small bowel involved CD by double-balloon enteroscopy (DBE) were retrospectively reviewed. They were divided into two groups based on whether colon involved: isolated small bowel involved (case group) and small bowel + colon involved (control group). Results: 204 patients (154 males and 50 females) with small bowel involved CD (98 in case group and 106 in control group) were chosen. Compared with the control group, the case group had a higher proportion of bowel resection history and stricturing behaviour, while had a lower proportion of elevated platelet and erythrocyte sedimentation rate level. The two groups had no difference in bowel resection risk since the DBE procedure (P=0.277), but the case group had a higher probability since the onset of the symptoms (P=0.003). Diagnosis at > 40-year-old, thickest bowel wall>7mm, and stricture found in DBE were risk factors for bowel resection, while patients with irregular ulcer, received infliximab, corticosteroids, or enteral nutrition after DBE may have a lower risk. Conclusion: The isolated small-bowel CD was concealed and would be easily overlooked, though they may be more serious. The prognosis might not be as bad as it used to be considered if the disease could be diagnosed, evaluated comprehensively, and treated appropriately early.