AI Article Synopsis
- Crohn's disease strictures are typically managed with a single endoscopic balloon dilation (EBD), but researchers explored the effectiveness of repeat EBD combined with needle-knife stricturotomy (NKSt) alongside aggressive drug therapy.
- In a study of 21 patients, those receiving intensive treatment (multiple EBDs and/or NKSt) showed a higher symptom improvement rate (72%) compared to those with a single EBD (40%).
- The findings suggest that repeat dilations and NKSt are safe and potentially more effective for treating strictures, especially when paired with enhanced drug treatment for inflammation.
Article Abstract
Background And Aims: Crohn's disease strictures are usually treated by a single endoscopic balloon dilation (EBD). We postulated repeat EBD and needle-knife stricturotomy (NKSt), together with inflammation controlled by intense drug therapy, may be more effective.
Methods: Twenty-one patients with symptomatic strictures were randomized to a single EBD or intensive treatment with 3 balloon dilations 3 weeks apart and/or NKSt.
Results: Of 21 patients, 2 of 5 (40%) undergoing a single EBD and 12 of 16 (72%) undergoing intensive treatment had symptom improvement (odds ratio, 4.49; 95% confidence interval, .54-37.4; P = .164). Eleven patients received >1 EBD without NKSt and 5 underwent ≥1 NKSt. NKSt-treated patients and those with concurrent intensified drug treatment had the best outcomes.
Conclusions: Treatment for Crohn's disease strictures with repeat dilations or stricturotomy is feasible and safe and may improve stricture outcomes. Concurrent intensified drug treatment to eliminate inflammation is also associated with improved outcomes. (Clinical trial registration number: NCT03222011.).
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| http://dx.doi.org/10.1016/j.gie.2024.09.031 | DOI Listing |
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