Endoscopic management of Crohn’s strictures

Talat Bessissow, Jason Reinglas, Achuthan Aruljothy, Peter L. Lakatos, Gert Van Assche

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Symptomatic intestinal strictures develop in more than one third of patients with Crohn’s disease (CD) within 10 years of disease onset. Strictures can be inflammatory, fibrotic or mixed and result in a significant decline in quality of life, frequently requiring surgery for palliation of symptoms. Patients under the age of 40 with perianal disease are more likely to suffer from disabling ileocolonic disease thus may have a greater risk for fibrostenotic strictures. Treatment options for fibrostenotic strictures are limited to endoscopic and surgical therapy. Endoscopic balloon dilatation (EBD) appears to be a safe, less invasive and effective alternative modality to replace or defer surgery. Serious complications are rare and occur in less than 3% of procedures. For non-complex strictures without adjacent fistulizaation or perforation that are less than 5 cm in length, EBD should be considered as first-line therapy. The aim of this review is to present the current literature on the endoscopic management of small bowel and colonic strictures in CD, which includes balloon dilatation, adjuvant techniques of intralesional injection of steroids and anti-tumor necrosis factor, and metal stent insertion. Short and long-term outcomes, complications and safety of EBD will be discussed.

Original languageEnglish
Pages (from-to)1859-1867
Number of pages9
JournalWorld journal of gastroenterology
Volume24
Issue number17
DOIs
Publication statusPublished - May 7 2018

Keywords

  • Crohn’s disease
  • Endoscopic balloon dilation
  • Endoscopy
  • Inflammatory bowel disease
  • Stenosis
  • Stricture

ASJC Scopus subject areas

  • Gastroenterology

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  • Cite this

    Bessissow, T., Reinglas, J., Aruljothy, A., Lakatos, P. L., & Assche, G. V. (2018). Endoscopic management of Crohn’s strictures. World journal of gastroenterology, 24(17), 1859-1867. https://doi.org/10.3748/wjg.v24.i17.1859