INTESTINE Vol.16 No.3(3-2)


特集名 クローン病のTherapeutic Strategy ─ mucosal healingは治療のゴールか
題名 クローン病治療選択・効果判定のための各種modalityの意義─小腸を中心に (2) カプセル小腸内視鏡検査法/バルーン小腸内視鏡検査法
発刊年月 2012年 05月
著者 山本 博徳 自治医科大学光学医療センター
【 要旨 】 クローン病の予後改善のための治療ゴールとしてmucosal healingの重要性が認識され始めている.クローン病における小腸病変の頻度は高く,狭窄などの合併症を起こしやすいため予後規定因子として重要性が高い.小腸病変は無症状のことも多く,症状,血液検査所見からの病勢把握は困難である.したがって小腸病変の客観的評価はクローン病治療選択・効果判定のために重要であり,mucosal healingの判定にはカプセル内視鏡,バルーン内視鏡の有用性が高い.また,バルーン内視鏡は小腸狭窄の内視鏡的拡張術にも有用である.
Theme Therapeutic strategy for Crohn's disease -- Should mucosal healing be a final goal?
Title Capsule endoscopy/balloon-assisted endoscopy
Author Hironori Yamamoto Endoscopy Center, Jichi Medical School
[ Summary ] In order to improve long-term outcomes for patients with Crohn's disease, mucosal healing must be recognized as an important therapeutic goal. Crohn's disease has a high incidence of small intestinal lesions which is important in determining the prognosis by causing complications such as strictures. It is often difficult to estimate disease activity in the small intestine because small intestinal lesions may be asymptomatic with minimumal or no change in laboratory findings. Therefore, subjective evaluation of small intestinal lesions is important to determine therapeutic strategies for Crohn's disease treatment. Endoscopic observation, using capsule endoscopy and balloon-assisted endoscopy is very useful for evaluation of mucosal healing of small intestinal lesions. Moreover, balloon-assisted endoscopy is useful for endoscopic balloon dilation of small intestinal strictures observed in Crohn's disease.
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