Long-term follow-up of the endoscopic treatment of strictures in pediatric and adult patients with inflammatory bowel disease

Erina N. Foster, J. Antonio Quiros, Thomas P Prindiville

Research output: Contribution to journalArticle

33 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)880-885
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume42
Issue number8
DOIs
StatePublished - Sep 2008

Fingerprint

Inflammatory Bowel Diseases
Pathologic Constriction
Pediatrics
Dilatation
Therapeutics
Triamcinolone
Sigmoid Colon
Crohn Disease
Abscess
Medical Records
Rupture
Steroids
Hemorrhage

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 journalArticle

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