The Use of Serial Balloon-Assisted Enteroscopies in the Monitoring and Management of Patients With Small Bowel Crohnʼs Disease
Bibliographic record
Abstract
Introduction: Balloon Assisted Enteroscopy (BAE) consists of two endoscopic procedures: Double Balloon Endoscopy (DBE) and Single Balloon Endoscopy (SBE). BAE provides the ability to both visualize the small bowel mucosa and to provide therapeutic interventions. By using BAE serially, physicians are able to monitor disease progression and response to therapy, as well as treat obstructive symptoms. This study aims to investigate the efficacy and safety of serial BAE in the maintenance and monitoring of small bowel CD patients. Methods: A retrospective chart review was undertaken to examine all patients with small bowel CD who had more than one BAE. Data collection included patient demographics (age at BAE, duration of disease), indications for BAE (obstructive symptoms, disease activity assessment, query CD), operational outcomes (medication escalation, recommendation of surgery, further imaging, or additional BAE), stricture dilation data (anastomotic vs. native, dilation diameter, number of successful/failed dilations), and medication information (biologics, immunosuppressives, corticosteroids, 5-ASAs). Results: 37 BAEs (7 SBE, 30 DBE) were carried out on 15 patients (10 male), a mean of 2.4 procedures/patient (range: 2-5). The mean age at BAE was 42.1y with average disease duration of 15 years. 16 patients (43%) were seen for disease assessment, 16 (43%) for obstructive symptoms, and 5 (14%) for suspected CD. Outcomes included medication escalation or maintenance and recommendations towards surgical resection, further alternative imaging, or follow-up BAE. 1 (6.7%) patient underwent a surgical resection between BAEs. 10 patients (66%) underwent 19 (51%) BAEs for stricture dilations, in which 41 strictures were dilated; 26 primary and 16 anastomotic. The average diameter of dilation was 16 mm. 7 strictures (17%) were considered non-traversable by the endoscope. The complication rate was 2.7% (1 patient experienced pancreatitis). No other complications were noted. Conclusion: BAE is an effective and safe modality for maintenance and monitoring of small bowel CD. Both DBE and SBE provide the ability to visualize the small bowel with minimal risk of perforation or complication. Both procedures are effective for diagnosis of small bowel CD as well as therapeutic intervention, in particular, stricture dilation. Serial BAE allows for enhanced management and decisionmaking in the care of small bowel CD patients.Table 1: Procedural data for patients with known or query Crohn's undergoing serial balloon assisted enteroscopyTable 2: Post-procedural outcome data for patients with known or query Crohn's undergoing serial balloon assisted enteroscopy
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".