Endoscopic dilation is an efficacious and safe treatment of intestinal strictures in <scp>C</scp>rohn's disease

Gustavsson, Anders; Magnuson, Anders; Blomberg, Björn; Andersson, Magnus; Halfvarson, Jonas; Tysk, Curt

doi:10.1111/j.1365-2036.2012.05146.x

Cited by 124 publications

(92 citation statements)

References 42 publications

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“…Up to 34 % of the patients may expect a great benefit only after one procedure and further 24 % with repeated sessions [8]. Patients who got a first ED are at high risk of CD recurrence [91], since symptom recurrence after ED is common and has been reported in 13-100 % of patients [97]. Therefore, patients have to be followed up regularly to evaluate the symptomatic relief (general well-being, presence of abdominal pain or clear obstructive symptoms).…”

Section: Endoscopic Dilationmentioning

confidence: 99%

Multidisciplinary Management of Gastrointestinal Fibrotic Stenosis in Crohn’s Disease

et al. 2014

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Crohn's disease (CD) is a chronic inflammatory bowel disease that can involve virtually any part of the gastrointestinal tract. CD complications are the main indications for surgery. A large proportion of these interventions are due to stricturing disease. Although immunosuppressive treatments have been used more frequently during the last 25 years, there is no significant decrease in the need for surgery in patients with CD. Unfortunately, surgery is not curative, as the disease ultimately reoccurs in a substantial subset of patients. To best identify the patients who will require a specific treatment and to plane the most appropriate therapeutic approach, it is important to precisely define the type, the size, and the location of CD stenosis. Diagnostic approaches aim to distinguish fibrotic from inflammatory strictures. Medical therapy is required for inflammatory stenosis. Mechanical treatments are required when fibrotic CD strictures are symptomatic. The choice between endoscopic balloon dilation, stricturoplasty, and laparoscopic or open surgery is based on the presence of perforating complications, the remaining length of small bowel, and the number and length of strictures. The non-hierarchical decision-making process for the treatment of fibrotic CD therefore requires multidisciplinary clinical rounds with radiologists, gastroenterologists, interventional endoscopists, and surgeons.

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Section: Endoscopic Dilationmentioning

confidence: 99%

Multidisciplinary Management of Gastrointestinal Fibrotic Stenosis in Crohn’s Disease

et al. 2014

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“…[33][34][35] In a large retrospective study, 178 patients who had EBD for stricturing CD were followed up; at 5 years, 52% patients either had no dilation or required 1 additional dilation, whereas 36% underwent surgical resection. 36 Balloon dilation to 25 mm or more significantly increased the risk for perforation up to 10%; hence, balloons in the range of 10 to 20 mm are recommended depending on the severity of the stricture. 34 We use 5.5-cm long balloons for stability and controlled dilation to a diameter of 18 mm if possible using CRE balloon (Boston Scientific, Inc., Boston, MA).…”

Section: Endoscopic Balloon Dilationmentioning

confidence: 99%

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Tharian

George

Navaneethan

2016

Inflammatory Bowel Diseases

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The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.

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“…A stricture length equal to or less than 4 cm was associated with a surgery-free outcome. A large series of 776 dilations in 178 CD patients was recently reported, 80 % of which were on anastomotic strictures [122]. Technical success rate was 89 %.…”

Section: Infliximab and Other Anti-tumor Necrosis Factor Antibodies Amentioning

confidence: 99%

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

Ramakrishna

Makharia

Ahuja

et al. 2015

Indian J Gastroenterol

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In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

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Endoscopic dilation is an efficacious and safe treatment of intestinal strictures in Crohn's disease

Abstract: SUMMARY BackgroundBowel strictures are a major cause of morbidity, hospitalisation and surgery in Crohn's disease.

Cited by 124 publications

References 42 publications

Multidisciplinary Management of Gastrointestinal Fibrotic Stenosis in Crohn’s Disease

Multidisciplinary Management of Gastrointestinal Fibrotic Stenosis in Crohn’s Disease

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Indian Society of Gastroenterology consensus statements on Crohn’s disease in India

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