The role of each imaging modality and endoscopic treatment for small intestinal disease

There are several imaging modalities (e.g., abdominal ultrasound, CT, MRI, small bowel radiography, endoscopy) to diagnose small bowel diesease. To date, endoscopic modalities for small intestine, such as balloon-assisted enteroscopy (BAE) and capsule endoscopy (CE), have been developed and widely used for diagnosis and treatment. Since CE is a non-invasive method, this modality has been globally used for small bowel disorders. BAE has several advantages including direct observation and the ability of biopsy, compared with other small bowel modalities. Although CE and BAE are useful modalities, it is important to take into consideration pros and cons of each modality and use them in combination when necessary. With regard to endoscopic treatment for small bowel disease, BAE enables the endoscopists not only to observe the small intestine directly but also to perform the endoscopic treatments, such as hemostasis and endoscopic balloon dilation (EBD). In this lecture, I will talk about morphological characteristics of small bowel inflammatory bowel diseases (SIBDs), diagnosis of early Crohn’s disease (CD) and endoscopic treatments of SIBDs including EBD for small bowel stricture in patients with CD and other inflammatory diseases. I hope this lecture would be helpful in terms of the clinical practice for the participants of this international session.