Practical guidelines on endoscopic treatment for Crohn's disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group

Shen, Bo; Kochhar, Gursimran; Navaneethan, Udayakumar; Farraye, Francis A.; Schwartz, David A.; Iacucci, Marietta; Bernstein, Çharles N.; Dryden, Gerald W.; Cross, Raymond K.; Bruining, David H.; Kobayashi, Taku; Lukáš, Martin; Shergill, Amandeep K.; Li, Nan; Lukáš, Milan; Tang, Shou Jiang; Kotze, Paulo Gustavo; Kiran, Ravi P.; Dulai, Parambir S.; El‐Hachem, Sandra; Coelho–Prabhu, Nayantara; Thakkar, Shyam; Mao, Ren; Chen, Guodong; Zhang, Sheng‐Yu; Suárez, Begoña González; Lama, Yago González; Silverberg, Mark S.; Sandborn, William J.

doi:10.1016/s2468-1253(19)30366-8

Cited by 81 publications

(73 citation statements)

References 74 publications

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“…In fact, the recent consensus statement in the management of stricturing CD failed to provide guidance for endoscopic therapy for strictures at the strictureplasty site because of a lack of published data on this topic. 7 …”

Section: Discussionmentioning

confidence: 99%

Combined Endoscopic Stricturotomy and Balloon Dilation of Strictureplasty Site Stricture in Jejunal Crohn's Disease

Nobel

Shen

2020

ACG Case Rep J

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Patients who undergo surgical strictureplasty for jejunal Crohn's disease-associated strictures may develop severe stenosis at the inlet and outlet sites of the strictureplasty. There is currently no consensus on the optimal management of these strictureplasty-associated strictures because immunosuppressive medications will be ineffective and surgical reintervention, most commonly with bowel resection, is invasive and may introduce new complications. Endoscopic therapy may sometimes be the only valid option. We present a case of severe strictureplasty inlet and outlet strictures that were successfully treated with combined endoscopic stricturotomy and balloon dilation.

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Section: Discussionmentioning

confidence: 99%

Combined Endoscopic Stricturotomy and Balloon Dilation of Strictureplasty Site Stricture in Jejunal Crohn's Disease

Nobel

Shen

2020

ACG Case Rep J

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“…On long-term follow-up (3-50 months), none of the patients required stricture-related surgery [76]. The global interventional inflammatory bowel disease (IBD) group recommendations has positioned fully covered SEMS for refractory strictures in selected patients failing balloon dilatation and endoscopic stricturotomy [77].…”

Section: Therapeutic Daementioning

confidence: 99%

Role of Small Bowel Endoscopy in Diagnosis and Management of Inflammatory Bowel Disease: Current Perspective

Pal¹,

Reddy²,

Nabi³

2021

Endoscopy in Small Bowel Diseases

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The evaluation of small bowel in inflammatory bowel disease (IBD) is mainly performed in cases with newly diagnosed or suspected Crohn’s disease (CD). The available modalities for small bowel evaluation include radiological imaging (barium meal follow through, magnetic resonance enteroclysis, computed tomography enteroclysis) and small bowel endoscopy also known as enteroscopy. The main advantage of small bowel endoscopy over radiological imaging is that it allows for obtaining biopsy specimen required for histological confirmation of the diagnosis. Various endoscopic modalities for endoscopic evaluation of small bowel include push enteroscopy and device assisted enteroscopy (DAE). Push enteroscopy allows only limited evaluation of proximal small bowel. Therefore, DAE is generally preferred over push enteroscopy for small bowel evaluation. DAE includes single balloon enteroscopy, double balloon enteroscopy, and spiral enteroscopy. The available literature suggests that there is no significant difference in the diagnostic yield among the available DAE devices. Therefore, the choice of DAE is largely dependent on the availability as well as local expertise. More recently, motorised spiral enteroscopy has been introduced. The main advantage of this novel DAE is ease of use with the possibility of evaluating the entire small bowel via per-oral route. However, the data regarding the use of motorised spiral enteroscopy is limited and comparative trials are required in future.

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“…(3) endoscopic management of colitis-associated neoplasia. 1,2 COVID-19 from the highly contagious pathogen has imposed tremendous stress and burden on patients, health care providers (HCP), health care facilities, and society. It has been particularly challenging for IBD patients with the underlying disease, the use of ISM, malnutrition, complications (such as strictures, bleeding, and abscess), or their requirement of periodic diagnostic or therapeutic endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice

et al. 2021

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Background/Aims: Performance of diagnostic or therapeutic endoscopic procedures in inflammatory bowel disease (IBD) patients can be challenging during a viral pandemic; the main concerns being the safety and protection of patients and health care providers (HCP). The aim of this study is to identify endoscopic practice patterns and outcomes of IBD and coronavirus disease 19 (COVID-19) with a worldwide survey of HCP. Methods: The 20-item survey questionnaire was sent to physician members of the American Society for Gastrointestinal Endoscopy Special Interest Group in Interventional IBD, Chinese IBD Society Endoscopy Interest Group, and the China Crohn' s and Colitis Foundation. Results: A total of 141 respondents submitted valid responses. Nighty-five respondents (67.9%) reported that at least 25% of their scheduled emergent endoscopic procedures were canceled or postponed during the pandemic. Fifty-six respondents (40.0%) have performed emergent endoscopy during the pandemic. A few respondents (9/140, 6.4%) estimated that more than 25% of their patients had worsened disease due to delayed or canceled emergent endoscopy procedures. More than 80% of respondents believed that personal protective equipment (PPE) for the endoscopy team, room sterilization, and pre-procedure screening of patients for COVID-19 were necessary. Out of 140 respondents, 16 (11.4%) reported that several of their patients had COVID-19. Eight clinicians (5.7%) reported that they or their endoscopy colleagues developed work-related COVID-19. Conclusions: Cancellation of elective and emergent endoscopy in IBD care during the pandemic was common. Few respondents reported that their patients' disease conditions worsened due to the cancellation of the endoscopy procedure. Most respondents voiced the need for proper PPE during the procedure regardless of patients' CO-VID-19 status and screening the patients for COVID-19.

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Practical guidelines on endoscopic treatment for Crohn's disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group

Cited by 81 publications

References 74 publications

Combined Endoscopic Stricturotomy and Balloon Dilation of Strictureplasty Site Stricture in Jejunal Crohn's Disease

Combined Endoscopic Stricturotomy and Balloon Dilation of Strictureplasty Site Stricture in Jejunal Crohn's Disease

Role of Small Bowel Endoscopy in Diagnosis and Management of Inflammatory Bowel Disease: Current Perspective

Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice

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