Characteristics and prognosis of isolated small-bowel Crohn’s disease
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Previous studies suggest that Crohn’s disease (CD) with both small bowel and colon involvement is more serious than colonic CD. However, clinical features of isolated small-bowel CD have not been fully investigated.
In this retrospective case-control study, 89 patients were divided into two groups according to capsule endoscopy, ileocolonoscopy, and enhanced computed tomography results. The case group was isolated small-bowel CD (n = 50) and the control group was CD with both small bowel and colon involvement (n = 39). We collected data of the patients and analyze it.
In univariate analysis, isolated small-bowel CD group had higher percentage of stricture, Lewis score, platelet, plateletcrit and lower Harvey-Bradshaw index, high-sensitivity C-reactive protein, and erythrocyte sedimentation rate. In multivariable analysis, it had lower Harvey-Bradshaw index (p = 0.000), which meaned relatively mild symptoms. However, it had higher Lewis score (p = 0.007), which meaned more serious small-bowel inflammation. The Kaplan-Meier survival curve also suggested that isolated small-bowel CD patients were more likely to accept partial small intestinal resection surgery (p = 0.029).
Isolated small-bowel CD is easily overlooked for milder clinical symptoms and relatively limited lessions, but severe small-bowel histological injury results in owing worse clinical outcomes. Clinicians should pay more attention to the isolated small-bowel CD and take aggressive intervention during therapy.
KeywordsInflammatory bowel disease Capsule endoscopy Small bowel Colon
CCX, DJ, DHJ, and CHT designed the research; SLY and ZZC collected material and clinical data from patients; DHJ, ZBL, and XWW analyzed data; DJ and DHJ contributed to drafting the manuscript; CCX, CHT, XWW, SLY, and ZBL revised the manuscript; all authors approved the final version of the manuscript.
This work was supported by the Major Science and Technology Project of Medical and Health of Zhejiang Province of China, No.WKJ-ZJ-1516.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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