P202 Crohn’s disease extent and small bowel inflammatory activity: Results of a small bowel capsule endoscopy study

Abstract

Background Small bowel capsule endoscopy (SBCE) enables the direct visualisation of the entire small bowel (SB) mucosa and the application of the Lewis score allows the reliable assessment of the SB mucosal inflammatory activity in Crohn’s disease (CD) patients. The study aim was to investigate the association of disease location, extent and inflammatory activity in CD patients with the use of SBCE Methods Retrospective study of 80 consecutive patients with an established CD that underwent SBCE in the Gastroenterology Department of the University Hospital of Ioannina between January 2007 and October 2019, for the evaluation of disease extent and disease activity. Results Fifty-one patients had evidence of endoscopic disease activity. In 30 of these patients (58.8%), the disease was located in the ileum and proximal SB, whereas in 20 patients (39.2%) the disease was located solely in the terminal ileum. In one patient (2%) treated with adalimumab, the disease was located solely in the jejunum. Eight patients (15.7%) had evidence of disease activity in the upper GI. All patients with upper GI disease activity demonstrated proximal SB disease involvement. The median Lewis score in patients with proximal CD was 1350 (mean 1666.3; Std 1343) median) against 458 (mean 1548,6; Std 1751) in patients with disease located in the ileum (p = 0.10). Conclusion In our study, proximal small bowel disease involvement was present in >50% of CD patients. Upper GI involvement was associated with extensive SB disease. Patients with proximal SB CD demonstrated a higher median Lewis score compared with those with CD located solely in the terminal ileum.