David Bruining, M. D., discusses a recent study published in the Inflammatory Bowel Diseases journal about Crohn's disease strictures. The study results highlight a move toward noninvasive or non-surgical approaches for Crohn's disease patients.
Crohn's disease initially begins as an inflammatory process. For many patients, it grows to be fibrostenotic disease manifesting in strictures. Endoscopic dilatation of Crohn's disease is an important topic because a third of Crohn's disease patients will develop strictures from surgery over ten years. Eighty percent of Crohn's disease patients will have surgery over a lifetime.
This study, completed by four academic institutes in the United Kingdom, looked at 79 patients with Crohn's disease related strictures. The results showed that endoscopic dilatation was technically successful in more than three-fourths of the patients. Clinical success, defined as improvement in symptoms and the absence of stricture at follow up, was found in 34% of the patients after the first dilatation. Forty-three percent of the patients benefited from a second dilatation.
This study highlights the movement toward noninvasive or non-surgical approaches. It should be noted that most of the patients in this study had a stricture the length of two centimeters or less and many had post-operative strictures.
Mayo Clinic does offer this procedure when clinical appropriate for patients with Crohn's disease.
The full study can be found online here.
For more information on IBD, visit mayoclnic.org/ibd.
Dr. Bruining is a gastroenterologist at Mayo Clinic.