MRE vs barium swallow for proximal strictures

What is known

• In a surgical-comparison series, MRE matched or exceeded prior accuracy for small bowel disease but discrete proximal small bowel lesions were noted as not always detected. ¹
• Standard oral-contrast MRE frequently gives inadequate proximal small bowel distension; enteroclysis improves proximal distension without a demonstrated gain in diagnostic yield. ^2,3
• Endoscopic techniques are cited as 20–40% more sensitive than imaging for proximal small bowel lesion detection, and proximal/duodenal disease is a listed trigger for DBE. ^4,5

What is unknown / caveats

• No retrieved study directly compares MRE with barium swallow / small bowel follow-through
• Proximal small bowel lesion yield in these series is low, limiting firm conclusions on stricture detection
• Most validation is against conventional enteroclysis or surgery, not barium swallow
• The corpus does not contain the specific MRE-versus-barium-swallow stricture comparison the question asks about.

References

1. Fallis SA, Murphy P, Sinha R, Hawker P, Gladman L, Busby K, Sanders S. Magnetic resonance enterography in Crohn's disease: a comparison with the findings at surgery. Colorectal Dis. 2013. PMID: 23869486.

2. Bekendam MIJ, Puylaert CAJ, Phoa SKSS, Nio CY, Stoker J. Shortened oral contrast preparation for improved small bowel distension at MR enterography. Abdom Radiol (NY). 2017. PMID: 28393302.

3. Masselli G, Casciani E, Polettini E, Gualdi G. Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn's disease. Eur Radiol. 2008. PMID: 17899102.

4. Maconi G, Sorin V, Kopylov U, Barzilay O, Ferretti F, Innamorati S, Tonolini M, Eliakim R, Amitai MM. Diagnostic significance of mesenteric lymph node involvement in proximal small bowel Crohn's disease. Ther Adv Gastroenterol. 2022. PMID: 36035308.

5. Sheehan T, Hegarty C, Connaughton R, Hall B, Kelly OB. Positioning double-balloon enteroscopy in the diagnostic algorithm for suspected small bowel Crohn's disease: a retrospective analysis of decision-making at a tertiary referral centre. Front Gastroenterol (Lausanne). 2026. PMID: 41993704.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.