Endoscopic Management of Crohn’s Disease Strictures

Abstract

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract which can result in luminal stenosis and up to 90% of patients requiring surgery during their lifetime. Medical management aims to reduce the inflammatory burden to prevent the development of inflammatory strictures, progression to fibro-stenosis and subsequent obstructive symptoms. Endoscopic balloon dilatation (EBD) is a well-established, safe technique in the management of short strictures to prevent patients having multiple surgical resections. In this review the evidence and safety of EBD for colonic and small bowel strictures will be discussed as well as adjuvant techniques (including endoscopic stenting and endoscopic intralesional therapy), current trials and new evidence on the medical management of stricturing disease.