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Magnetic resonance enterography or video capsule endoscopy – what do Crohn’s disease patients prefer?

Authors Lahat A, Kopylov U, Amitai M, Neuman S, Levhar N, Yablecovitch D, Avidan B, Yanai H, Dotan I, Chowers Y, Weiss B, Ben-Horin S, Eliakim R

Received 2 November 2015

Accepted for publication 2 February 2016

Published 8 June 2016 Volume 2016:10 Pages 1043—1050

DOI https://doi.org/10.2147/PPA.S99690

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Adi Lahat,1,2 Uri Kopylov,1,2 Marianne M Amitai,3 Sandra Neuman,1,2 Nina Levhar,1,2 Doron Yablecovitch,1,2 Benjamin Avidan,1,2 Henit Yanai,2,4 Iris Dotan,2,4 Yehuda Chowers,5,6 Batya Weiss,7 Shomron Ben-Horin,1,2,* Rami Eliakim1,2,*

On behalf of the Israeli IBD Research Network (IIRN)

1Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel; 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Israel; 4IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv, Isarel; 5Rambam Health Care Campus, Haifa, Israel; 6Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel; 7Edmond and Lily Safra Children’s Hospital, Tel Hashomer, Israel

*These authors contributed equally to this work

Background: Despite differences in the information obtained by capsule endoscopy (CE) and magnetic resonance enterography (MRE), one of these modalities is usually needed when evaluating disease activity. There are no data on patients’ preference that would help guide the choice between these two modalities in these instances.
Aim: To compare patients’ tolerance and preference to MRE versus CE.
Patients and methods: Patients with known small bowel Crohn’s disease (CD) in clinical remission (Crohn’s disease activity index  [CDAI] <150) or with mild symptoms (CDAI <220) were prospectively recruited. All patients underwent MRE followed by CE. Patients were asked to fill out a questionnaire addressing specific points regarding inconvenience during the preparation for the procedures, the procedures, and postprocedures. Side effects and procedure preference were addressed. Questionnaires were included for analysis only when more than 95% of the items were addressed.
Results: Fifty-six patients fulfilled inclusion criteria. Pre-exam discomfort, during-exam discomfort, nausea, vomiting, bloating, and abdominal pain were all significantly more prominent in MRE as compared to CE (P<0.0001, P<0.0001, P<0.0001, P=0.009, P=0.0002, P<0.0001, respectively). MRE was perceived as a more difficult procedure (P<0.0001). Furthermore, MRE was associated with a specific adverse event – claustrophobia. Seventy-eight percent of patients (44 patients) preferred to repeat CE as compared to 22% (P<0.0001) who preferred MRE.
Conclusion: CE was better tolerated by CD patients compared to MRE and was preferred by 78% of patients. The superior tolerability of CE should be considered along with the diagnostic features, and more data sought when choosing between these two modalities for CD patients for long-term follow-up.

Keywords: inflammatory bowel disease, Crohn’s imaging, MRE, capsule endoscopy, patients’ preference
 

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