Abstract
BACKGROUND: Strictures are a common complication of inflammatory bowel disease (IBD) and are usually treated by surgical resection or strictureplasty. As an alternative to surgery, endoscopic balloon dilation and steroid injection have been used to relieve symptoms. GOALS: To assess patient or stricture characteristics that may predict a better outcome and duration of response as endoscopic therapy is not without its risks. STUDY: A retrospective review of patients with IBD strictures who underwent dilations between 1996 and 2005 was performed. The patients were followed in the adult and pediatric IBD clinics at a single center. Information was collected from medical records. RESULTS: Strictures were identified in the small and large bowel of 24 patients (22 adult and 2 pediatric). The majority had Crohn's disease (22/24). In total, 71 dilations were performed on 29 strictures; 46 dilations for 17 strictures were augmented with triamcinolone. Mean duration of follow-up was 32 months. This study included 1 stomal, 12 anastomotic, and 16 de novo strictures. Of 12 anastomotic strictures, 6 were complex. Endoscopic dilation was uneventful in 22/24 patients. Bleeding and perforation occurred on separate occasions in 1/6 complex stricture patients and rupture of a paracolonic abscess in another patient with a de novo sigmoid stricture. Surgery was performed on 2 patients, 1 for refractory disease and 1 for noncompliance with therapy. CONCLUSIONS: Endoscopic dilation can provide long-term effective palliation of symptoms with minimal risk in patients with simple strictures. Complex anastomotic strictures are technically more challenging compared with de novo strictures.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 880-885 |
| Number of pages | 6 |
| Journal | Journal of Clinical Gastroenterology |
| Volume | 42 |
| Issue number | 8 |
| DOIs | |
| State | Published - Sep 2008 |
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Keywords
- Dilation
- Endoscopy
- Inflammatory bowel disease
- Strictures
ASJC Scopus subject areas
- Gastroenterology
Cite this
Long-term follow-up of the endoscopic treatment of strictures in pediatric and adult patients with inflammatory bowel disease. / Foster, Erina N.; Quiros, J. Antonio; Prindiville, Thomas P.
In: Journal of Clinical Gastroenterology, Vol. 42, No. 8, 09.2008, p. 880-885.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term follow-up of the endoscopic treatment of strictures in pediatric and adult patients with inflammatory bowel disease
AU - Foster, Erina N.
AU - Quiros, J. Antonio
AU - Prindiville, Thomas P
PY - 2008/9
Y1 - 2008/9
N2 - BACKGROUND: Strictures are a common complication of inflammatory bowel disease (IBD) and are usually treated by surgical resection or strictureplasty. As an alternative to surgery, endoscopic balloon dilation and steroid injection have been used to relieve symptoms. GOALS: To assess patient or stricture characteristics that may predict a better outcome and duration of response as endoscopic therapy is not without its risks. STUDY: A retrospective review of patients with IBD strictures who underwent dilations between 1996 and 2005 was performed. The patients were followed in the adult and pediatric IBD clinics at a single center. Information was collected from medical records. RESULTS: Strictures were identified in the small and large bowel of 24 patients (22 adult and 2 pediatric). The majority had Crohn's disease (22/24). In total, 71 dilations were performed on 29 strictures; 46 dilations for 17 strictures were augmented with triamcinolone. Mean duration of follow-up was 32 months. This study included 1 stomal, 12 anastomotic, and 16 de novo strictures. Of 12 anastomotic strictures, 6 were complex. Endoscopic dilation was uneventful in 22/24 patients. Bleeding and perforation occurred on separate occasions in 1/6 complex stricture patients and rupture of a paracolonic abscess in another patient with a de novo sigmoid stricture. Surgery was performed on 2 patients, 1 for refractory disease and 1 for noncompliance with therapy. CONCLUSIONS: Endoscopic dilation can provide long-term effective palliation of symptoms with minimal risk in patients with simple strictures. Complex anastomotic strictures are technically more challenging compared with de novo strictures.
AB - BACKGROUND: Strictures are a common complication of inflammatory bowel disease (IBD) and are usually treated by surgical resection or strictureplasty. As an alternative to surgery, endoscopic balloon dilation and steroid injection have been used to relieve symptoms. GOALS: To assess patient or stricture characteristics that may predict a better outcome and duration of response as endoscopic therapy is not without its risks. STUDY: A retrospective review of patients with IBD strictures who underwent dilations between 1996 and 2005 was performed. The patients were followed in the adult and pediatric IBD clinics at a single center. Information was collected from medical records. RESULTS: Strictures were identified in the small and large bowel of 24 patients (22 adult and 2 pediatric). The majority had Crohn's disease (22/24). In total, 71 dilations were performed on 29 strictures; 46 dilations for 17 strictures were augmented with triamcinolone. Mean duration of follow-up was 32 months. This study included 1 stomal, 12 anastomotic, and 16 de novo strictures. Of 12 anastomotic strictures, 6 were complex. Endoscopic dilation was uneventful in 22/24 patients. Bleeding and perforation occurred on separate occasions in 1/6 complex stricture patients and rupture of a paracolonic abscess in another patient with a de novo sigmoid stricture. Surgery was performed on 2 patients, 1 for refractory disease and 1 for noncompliance with therapy. CONCLUSIONS: Endoscopic dilation can provide long-term effective palliation of symptoms with minimal risk in patients with simple strictures. Complex anastomotic strictures are technically more challenging compared with de novo strictures.
KW - Dilation
KW - Endoscopy
KW - Inflammatory bowel disease
KW - Strictures
UR - http://www.scopus.com/inward/record.url?scp=54549113109&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=54549113109&partnerID=8YFLogxK
U2 - 10.1097/MCG.0b013e3181354440
DO - 10.1097/MCG.0b013e3181354440
M3 - Article
C2 - 18645528
AN - SCOPUS:54549113109
VL - 42
SP - 880
EP - 885
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
SN - 0192-0790
IS - 8
ER -