Endoscopic Balloon Dilation Therapy for Small Intestinal Strictures with Crohn's Disease Using Double Balloon Endoscopy

AbstractObstruction from stricturing Crohn's disease remains one of the most common reasons for intervention. Acute inflammation is often responsive to medications, but chronic fibrosis is unlikely to respond and will generally go on to require additional treatment. Newer methods, such as endoscopic balloon dilation, are gaining grounds in strictures that are amenable, but with high recurrence and strictures that may not be endoscopically accessible, surgery still plays a key role in the treatment of obstructing Crohn's disease.

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Repeated endoscopic balloon dilation for an ileocecal stricture with an internal fistula for a patient with Crohn's disease

Progress of Digestive Endoscopy ◽

10.11641/pde.95.1_72 ◽

2019 ◽

Vol 95 (1) ◽

pp. 72-74

Author(s):

Yusuke Sakurai ◽

Hirotsugu Sakamoto ◽

Tomonori Yano ◽

Keijiro Sunada ◽

Hironori Yamamoto

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Balloon Dilation ◽

Endoscopic Balloon Dilation ◽

Internal Fistula ◽

Endoscopic Balloon

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A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn’s Disease

Gastroenterology Research and Practice ◽

10.1155/2016/1085027 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Masanao Nakamura ◽

Yoshiki Hirooka ◽

Osamu Watanabe ◽

Takeshi Yamamura ◽

Kohei Funasaka ◽

...

Keyword(s):

Multivariate Analysis ◽

Differential Diagnosis ◽

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Balloon Dilation ◽

Retrospective Evaluation ◽

Double Balloon Endoscopy ◽

Double Balloon

Background. Although the usefulness of capsule endoscopy (CE) and double-balloon endoscopy (DBE) for the evaluation of Crohn’s disease (CD) is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit.Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications.Results. CE results were assessed as useful indications in 28 (45%) of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77%) of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis.Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis.

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