Endoscopic stricture management in inflammatory bowel disease: Present and future

Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis. 2002;8:244–50. https://doi.org/10.1097/00054725-200207000-00002.

Article  PubMed  Google Scholar 

Navaneethan U, Lourdusamy D. Endoscopic stricturotomy and strictureplasty. Gastrointest Endosc Clin N Am. 2022;32:687–97. https://doi.org/10.1016/j.giec.2022.05.002.

Article  PubMed  Google Scholar 

El Ouali S, Click B, Holubar SD, Rieder F. Natural history, diagnosis and treatment approach to fibrostenosing Crohn’s disease. United European Gastroenterol J. 2020;8(3):263–70. https://doi.org/10.1177/2050640620901960.

Article  PubMed  PubMed Central  Google Scholar 

Gordon IO, Bettenworth D, Bokemeyer A, et al. Histopathology scoring systems of stenosis associated with small bowel Crohn’s disease: A systematic review. Gastroenterology. 2020;158:137–50.e1. https://doi.org/10.1053/j.gastro.2019.08.033.

Frolkis AD, Lipton DS, Fiest KM, et al. Cumulative incidence of second intestinal resection in Crohn’s disease: a systematic review and meta-analysis of population-based studies. Am J Gastroenterol. 2014;109:1739–48. https://doi.org/10.1038/ajg.2014.297.

Article  PubMed  Google Scholar 

Kalman TD, Everhov ÅH, Nordenvall C, et al. Decrease in primary but not in secondary abdominal surgery for Crohn’s disease: nationwide cohort study, 1990–2014. Br J Surg. 2020;107:1529–38. https://doi.org/10.1002/bjs.11659.

Article  CAS  PubMed  Google Scholar 

Lan N, Stocchi L, Ashburn JH, et al. Outcomes of endoscopic balloon dilation vs surgical resection for primary ileocolic strictures in patients with Crohn’s disease. Clin Gastroenterol Hepatol. 2018;16:1260–7. https://doi.org/10.1016/j.cgh.2018.02.035.

Article  PubMed  Google Scholar 

Pal P, Gala J, Rebala P, et al. Re-intervention rates and symptom-free survival at 1 year after endoscopic versus surgical management of strictures in Crohn’s disease: A propensity matched analysis of a prospective inflammatory bowel disease cohort. J Gastroenterol Hepatol. 2024;39:353–9. https://doi.org/10.1111/jgh.16384.

Rieder F, Bettenworth D, Ma C, et al. An expert consensus to standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Crohn’s disease. Aliment Pharmacol Ther. 2018;48:347–57. https://doi.org/10.1111/apt.14853.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bettenworth D, Baker ME, Fletcher JG, et al. A global consensus on the definitions, diagnosis and management of fibrostenosing small bowel Crohn’s disease in clinical practice. Nat Rev Gastroenterol Hepatol. 2024;21:572–84. https://doi.org/10.1038/s41575-024-00935-y.

Article  PubMed  PubMed Central  Google Scholar 

Lu C, Rosentreter R, Parker CE, et al. International expert guidance for defining and monitoring small bowel strictures in Crohn’s disease on intestinal ultrasound: a consensus statement. Lancet Gastroenterol Hepatol. 2024;9:1101–10. https://doi.org/10.1016/S2468-1253(24)00265-6.

Article  CAS  PubMed  Google Scholar 

Levy AN. Diagnosis and classification of inflammatory bowel disease strictures. Gastrointest Endosc Clin N Am. 2022;32:615–29. https://doi.org/10.1016/j.giec.2022.04.001.

Article  PubMed  Google Scholar 

Lashner BA, Turner BC, Bostwick DG, Frank PH, Hanauer SB. Dysplasia and cancer complicating strictures in ulcerative colitis. Dig Dis Sci. 1990;35:349–52. https://doi.org/10.1007/bf01537413.

Article  CAS  PubMed  Google Scholar 

Bopanna S, Kedia S, Das P, et al. Long-term follow-up reveals high incidence of colorectal cancer in Indian patients with inflammatory bowel disease. United European Gastroenterol J. 2017;5:708–14. https://doi.org/10.1177/2050640616680552.

Article  Google Scholar 

Shen B, Kochhar G, Navaneethan U, et al. Practical guidelines on endoscopic treatment for Crohn’s disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group. Lancet Gastroenterol Hepatol. 2020;5:393–405. https://doi.org/10.1016/s2468-1253(19)30366-8.

Article  PubMed  Google Scholar 

Shen B. Chapter 10 - Principles of endoscopic therapy in inflammatory bowel diseases. In: Shen B, ed. Interventional Inflammatory Bowel Disease: Endoscopic Management and Treatment of Complications: Academic Press; 2018; p. 119–35.

Kumar P, Jena A, Birda CL, et al. Safety and efficacy of non-fluoroscopic endoscopic dilatation of gastrointestinal tuberculosis related strictures. BMC Gastroenterol. 2022;22:60. https://doi.org/10.1186/s12876-022-02140-0.

Article  PubMed  PubMed Central  Google Scholar 

Pal P, Gupta R, Tandan M, Reddy DN. Segmental layered incision and circumferential endoscopic dissection technique of endoscopic stricturotomy for safe, staged endoscopic dissection of complex luminal stricture. VideoGIE. 2025;11:4–8. https://doi.org/10.1016/j.vgie.2025.08.007

Rieder F, Zimmermann EM, Remzi FH, Sandborn WJ. Crohn’s disease complicated by strictures: a systematic review. Gut. 2013;62:1072–84. https://doi.org/10.1136/gutjnl-2012-304353.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bossuyt P, Debeuckelaere C, Ferrante M, et al. Risk stratification for surgery in stricturing ileal Crohn’s disease: the BACARDI risk model. J Crohns Colitis. 2018;12:32–8. https://doi.org/10.1093/ecco-jcc/jjx110.

Article  PubMed  Google Scholar 

Yamamoto H, Yano T, Araki A, et al. Guidelines for endoscopic balloon dilation in treating Crohn’s disease-associated small intestinal strictures (supplement to the clinical practice guidelines for enteroscopy). Dig Endosc. 2022;34:1278–96. https://doi.org/10.1111/den.14429.

Article  PubMed  Google Scholar 

Ding NS, Yip WM, Choi CH, et al. Endoscopic dilatation of Crohn’s anastomotic strictures is effective in the long term, and escalation of medical therapy improves outcomes in the biologic era. J Crohns Colitis. 2016;10:1172–8. https://doi.org/10.1093/ecco-jcc/jjw072.

Article  PubMed  Google Scholar 

Hong SN, Kim JE, Kim ER, Chang DK, Kim YH. Enteroscopic balloon dilation in small bowel stricturing Crohn’s disease: long-term outcomes and risk factors for surgery in a single-center prospective observational study. United European Gastroenterol J . 2025;13:958–70. https://doi.org/10.1002/ueg2.12775.

Article  CAS  Google Scholar 

Narula N, Wong ECL, Dulai PS, et al. Outcomes of passable and non-passable strictures in clinical trials of Crohn’s disease: A post-hoc analysis. J Crohns Colitis. 2021;15:1649–57. https://doi.org/10.1093/ecco-jcc/jjab045.

Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): Determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021;160:1570–83. https://doi.org/10.1053/j.gastro.2020.12.031.

Lu C, Holubar SD, Rieder F. How I approach the management of stricturing Crohn’s disease. Am J Gastroenterol. 2019;114:1181–4. https://doi.org/10.14309/ajg.0000000000000199.

Article  PubMed  Google Scholar 

Ning SB, Yang H, Li B, et al. Balloon-assisted enteroscopy-based endoscopic stricturotomy for deep small bowel strictures from Crohn’s disease: First cohort study of a novel approach. Dig Liver Dis. 2023;55:1397–402. https://doi.org/10.1016/j.dld.2023.05.033.

Shen B, Adorno-Garayo CR. Initial safety and efficacy of a novel drug-coated balloon for treatment of benign intestinal strictures. iGIE. 2024;3:10–4. https://doi.org/10.1016/j.igie.2023.12.002.

Article  PubMed  PubMed Central  Google Scholar 

Pal P, Kanaganti S, Banerjee R, et al. Systematic review of endoscopic management of stricture, fistula and abscess in inflammatory bowel disease. Gastroenterol Insights. 2023;14:45–63.

Article  Google Scholar 

Bettenworth D, Bokemeyer A, Kou L, et al. Systematic review with meta-analysis: efficacy of balloon-assisted enteroscopy for dilation of small bowel Crohn’s disease strictures. Aliment Pharmacol Ther. 2020;52:1104–16. https://doi.org/10.1111/apt.16049.

Article  PubMed  PubMed Central  Google Scholar 

Bouhnik Y, Carbonnel F, Laharie D, et al. Efficacy of adalimumab in patients with Crohn’s disease and symptomatic small bowel stricture: a multicentre, prospective, observational cohort (CREOLE) study. Gut. 2018;67:53–60. https://doi.org/10.1136/gutjnl-2016-312581.

Article  CAS  PubMed  Google Scholar 

Bettenworth D, Gustavsson A, Atreja A, et al. A pooled analysis of efficacy, safety, and long-term outcome of endoscopic balloon dilation therapy for patients with stricturing Crohn’s disease. Inflamm Bowel Dis. 2017;23:133–42. https://doi.org/10.1097/mib.0000000000000988.

Article  PubMed  Google Scholar 

Reutemann BA, Turkeltaub JA, Al-Hawary M, et al. Endoscopic balloon dilation size and avoidance of surgery in stricturing Crohn’s disease. Inflamm Bowel Dis. 2017;23:1803–9. https://doi.org/10.1097/mib.0000000000001181.

Article  PubMed  PubMed Central  Google Scholar 

Hassan C, Zullo A, De Francesco V, et al. Systematic review: Endoscopic dilatation in Crohn’s disease. Aliment Pharmacol Ther. 2007;26:1457–64. https://doi.org/10.1111/j.1365-2036.2007.03532.x.

Di Nardo G, Oliva S, Passariello M, et al. Intralesional steroid injection after endoscopic balloon dilation in pediatric Crohn’s disease with stricture: a prospective, randomized, double-blind, controlled trial. Gastrointest Endosc. 2010;72:1201–8. https://doi.org/10.1016/j.gie.2010.08.003.

Article  PubMed  Google

Comments (0)

No login
gif