Chapter 16 endoscopic therapy of intestinal strictures: What is state of the art?

Abstract

Symptomatic intestinal strictures develop in more than one third of patients with Crohn’s disease during their lifetime. Strictures can be inflammatory, fibrotic or mixed. Fibrosis occurs as a result of excessive deposition of extracellular matrix protein. It can lead to severe symptoms affecting patients’ quality of life. As a result, patients will often need to undergo surgery to improve their symptoms. Endoscopic balloon dilatation appears to be a safe and effective alternative therapeutic procedure to replace or postpone surgery. It is less invasive and can be performed during a regular colonoscopy. Non-complex strictures that are ≤5 cm can be dilated endoscopically. Up to 80% of patients will have immediate relief of symptoms and it can prevent surgery in up to 70% of patients after a 3-year follow up. Serious complications are rare and occur in less than 3% of procedures.